Bronze Baby Syndrome

Ottinger, Daniele

doi:10.1891/0730-0832.32.3.200

Cited by 10 publications

(3 citation statements)

References 7 publications

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“…7 Liver disease should be ruled out in infants who develop BBS, because hepatocellular disease may be present in these patients with conjugated hyperbilirubinemia. 8 Collectively, these findings suggest that early recognition of BBS can guide further evaluation of hematologic and other disorders, but should not prevent the use of phototherapy for hyperbilirubinemia in infants with elevated levels of conjugated bilirubin. ■ Figure. A normally-pigmented Caucasian newborn infant experienced progressive but self-limited bronze-gray discoloration following initiation of phototherapy.…”

Section: Bronze Baby Syndromementioning

confidence: 97%

Bronze Baby Syndrome

Reese

2017

The Journal of Pediatrics

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Section: Bronze Baby Syndromementioning

confidence: 97%

Bronze Baby Syndrome

Reese

2017

The Journal of Pediatrics

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“…The exact etiology of bronzing is unknown, but the leading theory is that this occurs because of photodestruction of porphyrins that are released during hemolysis. 16 In our patient, maternal ingestion of naphthalene-containing mothballs during her third month of pregnancy resulted in hemolytic anemia, reticulocytosis, leukocytosis, and indirect hyperbilirubinemia in the infant. He required exchange transfusion for the treatment of hyperbilirubinemia and naphthalene toxicity.…”

Section: Discussionmentioning

confidence: 64%

Newborn Infant With Mothball Toxicity Due to Maternal Ingestion

et al. 2019

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Naphthalene poisoning due to exposure to mothballs is a common cause of toxicity in children worldwide. Naphthalene toxicity is known to cause hemolytic anemia, methemoglobinemia, and hepatic and renal injury. Neonates are more susceptible to the effects of oxidative stress from naphthalene because of their low glutathione stores and immaturity of hepatic enzymes. However, there are no reported cases of chronic fetal exposure to naphthalene during pregnancy. We report a novel case of chronic fetal exposure to naphthalene-containing mothballs that occurred from the second trimester through the third trimester of pregnancy. Our patient presented with hyperbilirubinemia, requiring exchange transfusion, severe hemolytic anemia, pulmonary hypertension, respiratory failure, and renal failure and progressed to develop “bronze baby” syndrome. Pregnant mothers should be diligently screened for such exposures and if found should receive psychiatric evaluation and counseling to prevent such devastating effects in neonates.

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“…Given, however, that the etiology of bronze baby syndrome is unclear, we must identify the photoproducts when treating bronze baby syndrome. We believe that the cause of the bronze color is the polymerized substances of bilirubin photoisomers and that those substances accumulate in the body of the neonatal infant .…”

Section: Adverse Reactions Of Phototherapy For Neonatal Hyperbilirubimentioning

confidence: 99%

Phototherapy for neonatal hyperbilirubinemia

Itoh

Okada

Kuboi

et al. 2017

Pediatrics International

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Approximately 60 years ago in England, phototherapy for neonatal hyperbilirubinemia was used in clinical practice. It was introduced in Japan approximately 50 years ago. At that time, the mechanism underlying the serum bilirubin concentration decrease by phototherapy was still unknown. The mechanism was identified by chemists, biochemists, and pediatricians. Clarification started with the report that unconjugated bilirubin was excreted into bile after photoirradiation in Gunn rats. After confirmation of the molecular structure of bilirubin on X-ray analysis, the mechanism for bile excretion of unconjugated bilirubin was verified based on geometric configurational photoisomers in the Gunn rat. Finally, the reaction and excretion of structural bilirubin photoisomers was proved to be the main mechanism for the decrease in serum bilirubin during phototherapy for neonatal hyperbilirubinemia, which differs from the mechanism in the Gunn rat. The most effective and safest light source and the optimal method to evaluate phototherapy, however, remain unknown. Moreover, as for bronze baby syndrome, which is a well-known adverse reaction to phototherapy, the etiology is unclear. Hence, we review phototherapy for hyperbilirubinemia including a fundamental understanding of the bilirubin photochemical reactions, and discuss the subclinical carcinogenic risk of phototherapy and the increased mortality rate of extremely low-birthweight infants due to aggressive phototherapy, which is becoming an increasing problem.

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Bronze Baby Syndrome

Cited by 10 publications

References 7 publications

Bronze Baby Syndrome

Bronze Baby Syndrome

Newborn Infant With Mothball Toxicity Due to Maternal Ingestion

Phototherapy for neonatal hyperbilirubinemia

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