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Kernicterus
Kevin R. Moore, MD; Miral D. Jhaveri, MD; P. Ellen Grant, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Bilirubin (BR) or posticteric encephalopathy
              • Definitions

                • Kernicterus or BR encephalopathy: Pathological BR staining of basal ganglia, brainstem, and hippocampi associated with hyperbilirubinemia

              IMAGING

              • General Features

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Helal NF et al: Characteristics and outcome of newborn admitted with acute bilirubin encephalopathy to a tertiary neonatal intensive care unit. World J Pediatr. 15(1):42-8, 2018
                                        2. Le Pichon JB et al: The neurological sequelae of neonatal hyperbilirubinemia: definitions, diagnosis and treatment of the kernicterus spectrum disorders (KSDs). Curr Pediatr Rev. 13(3):199-209, 2017
                                        3. Sarı S et al: Brain magnetic resonance imaging and magnetic resonance spectroscopy findings of children with kernicterus. Pol J Radiol. 80:72-80, 2015
                                        4. Watchko JF et al: Bilirubin-induced neurologic damage. N Engl J Med. 370(10):979, 2014
                                        5. Wisnowski JL et al: Magnetic resonance imaging of bilirubin encephalopathy: current limitations and future promise. Semin Perinatol. 38(7):422-8, 2014
                                        6. Bhutani VK et al: Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatr Res. 74 Suppl 1:86-100, 2013
                                        7. Christensen RD et al: Neonatal death suspected to be from sepsis was found to be kernicterus with G6PD deficiency. Pediatrics. 132(6):e1694-8, 2013
                                        8. Odutolu Y et al: Low bilirubin kernicterus with sepsis and hypoalbuminaemia. BMJ Case Rep. 2013, 2013
                                        9. Wallenstein MB et al: Jaundice and kernicterus in the moderately preterm infant. Clin Perinatol. 40(4):679-88, 2013
                                        10. Watchko JF et al: Bilirubin-induced neurologic damage--mechanisms and management approaches. N Engl J Med. 369(21):2021-30, 2013
                                        11. Okumura A et al: Kernicterus in preterm infants. Pediatrics. 123(6):e1052-8, 2009
                                        12. Gkoltsiou K et al: Serial brain MRI and ultrasound findings: relation to gestational age, bilirubin level, neonatal neurologic status and neurodevelopmental outcome in infants at risk of kernicterus. Early Hum Dev. 84(12):829-38, 2008
                                        13. Katar S et al: Clinical and cranial magnetic resonance imaging (MRI) findings of 21 patients with serious hyperbilirubinemia. J Child Neurol. 23(4):415-7, 2008
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Bilirubin (BR) or posticteric encephalopathy
                                                    • Definitions

                                                      • Kernicterus or BR encephalopathy: Pathological BR staining of basal ganglia, brainstem, and hippocampi associated with hyperbilirubinemia

                                                    IMAGING

                                                    • General Features

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Helal NF et al: Characteristics and outcome of newborn admitted with acute bilirubin encephalopathy to a tertiary neonatal intensive care unit. World J Pediatr. 15(1):42-8, 2018
                                                                              2. Le Pichon JB et al: The neurological sequelae of neonatal hyperbilirubinemia: definitions, diagnosis and treatment of the kernicterus spectrum disorders (KSDs). Curr Pediatr Rev. 13(3):199-209, 2017
                                                                              3. Sarı S et al: Brain magnetic resonance imaging and magnetic resonance spectroscopy findings of children with kernicterus. Pol J Radiol. 80:72-80, 2015
                                                                              4. Watchko JF et al: Bilirubin-induced neurologic damage. N Engl J Med. 370(10):979, 2014
                                                                              5. Wisnowski JL et al: Magnetic resonance imaging of bilirubin encephalopathy: current limitations and future promise. Semin Perinatol. 38(7):422-8, 2014
                                                                              6. Bhutani VK et al: Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatr Res. 74 Suppl 1:86-100, 2013
                                                                              7. Christensen RD et al: Neonatal death suspected to be from sepsis was found to be kernicterus with G6PD deficiency. Pediatrics. 132(6):e1694-8, 2013
                                                                              8. Odutolu Y et al: Low bilirubin kernicterus with sepsis and hypoalbuminaemia. BMJ Case Rep. 2013, 2013
                                                                              9. Wallenstein MB et al: Jaundice and kernicterus in the moderately preterm infant. Clin Perinatol. 40(4):679-88, 2013
                                                                              10. Watchko JF et al: Bilirubin-induced neurologic damage--mechanisms and management approaches. N Engl J Med. 369(21):2021-30, 2013
                                                                              11. Okumura A et al: Kernicterus in preterm infants. Pediatrics. 123(6):e1052-8, 2009
                                                                              12. Gkoltsiou K et al: Serial brain MRI and ultrasound findings: relation to gestational age, bilirubin level, neonatal neurologic status and neurodevelopmental outcome in infants at risk of kernicterus. Early Hum Dev. 84(12):829-38, 2008
                                                                              13. Katar S et al: Clinical and cranial magnetic resonance imaging (MRI) findings of 21 patients with serious hyperbilirubinemia. J Child Neurol. 23(4):415-7, 2008