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Original Article
Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study
Nidhi Jain, Ajay Kumar
Background: To evaluate the outcomes of jaundiced neonates using two different total serum bilirubin (TSB) thresholds for discontinuing phototherapy.
Purpose: The study aims to evaluate the outcomes of jaundiced neonates by comparing two different total serum bilirubin (TSB) thresholds for discontinuing phototherapy. Methods: All consecutive jaundiced neonates in a tertiary care hospital with a gestational age of ≥35 weeks and ≥3...
Neonatology (Perinatology)
Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial
Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi
Clin Exp Pediatr. 2024;67(5):249-256.   Published online March 26, 2024
Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia?
Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants.
Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay.
Systematic review and meta-analysis
Neurobehavior
Association between neonatal jaundice and autism spectrum disorders among children: a meta-analysis
Ensiyeh Jenabi, Saeid Bashirian, Salman Khazaei
Clin Exp Pediatr. 2020;63(1):8-13.   Published online November 7, 2019
Autism spectrum disorder is a common neurodevelopmental disorder with an unknown etiology. The correlation between neonatal jaundice and the risk of developing autism spectrum disorder was investigated previously. Some studies showed significant associations, whereas others demonstrated no association. In this meta-analysis, we pooled the results of observational studies to examine the association between neonatal jaundice and the risk of autism...
Original Article
Neonatology (Perinatology)
Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?
Zeinab A El-Kabbany, Nadin N Toaima, Tamer N Toaima, Mona Y Gamal EL-Din
Clin Exp Pediatr. 2017;60(12):385-389.   Published online December 22, 2017
Purpose

This study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates.

Methods

A total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using...

Genetics and Metabolism
Neonatal indirect hyperbilirubinemia and glucose-6-phosphate dehydrogenase deficiency
Hasan M. Isa, Masooma S. Mohamed, Afaf M. Mohamed, Adel Abdulla, Fuad Abdulla
Clin Exp Pediatr. 2017;60(4):106-111.   Published online April 25, 2017
Purpose

This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus.

Methods

This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between...

Predictors of nonresponse to intravenous immunoglobulin therapy in Kawasaki disease
Hyo Min Park, Dong Won Lee, Myung Chul Hyun, Sang Bum Lee
Clin Exp Pediatr. 2013;56(2):75-79.   Published online February 25, 2013
Purpose

It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD.

Methods

We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005...

Glutathione S-transferase polymorphism of neonatal hyperbilirubinemia in Korean neonates
Chang Seok Kang, Seung Su Hong, Ji Sook Kim, Eun Ryoung Kim
Clin Exp Pediatr. 2008;51(3):262-266.   Published online March 15, 2008
Purpose : Glutathione S-transferase (GST) is a polymorphic supergene family of detoxification enzymes that are involved in the metabolism of numerous diseases. Several allelic variants of GSTs show impaired enzyme activity and are suspected to increase the susceptibility to diseases. Bilirubin is bound efficiently by GST members. The most commonly expressed gene in the liver is GSTM1, and GSTT1 is...
The relationship between Gly71Arg and TATA box polymorphism of UGT1A1 gene and prolonged hyperbilirubinemia of breast milk feeding infant in Korean
Jae Myoung Lee, Young Ji Han, Ji Sook Kim, Eun Ryoung Kim
Clin Exp Pediatr. 2008;51(2):150-155.   Published online February 15, 2008
Purpose : It has been known that breast milk cause prolonged unconjugated hyperbilirubinemia. UGT1A1 is a important gene of uridine diphosphate glucuronosyltransferase (UGT) which has a major role of bilirubin metabolism. These findings suggest that there is a relationship between UGT1A1 gene mutation and prolonged jaundice of breast feeding infant. The aim of study was to investigate whether a polymorphism...
Clinical factors causing hyperbilirubinemia in patients with Kawasaki disease
Kyung Hee Moon, Ok Ran Kim, Seung Taek Yu, Myung Eun Hong, Chang Woo Lee, Du Young Choi, Yeon Kyun Oh, Jong Duk Kim, Hyang Suk Yoon
Clin Exp Pediatr. 2007;50(1):52-55.   Published online January 15, 2007
Purpose : Hyperbilirubinemia, jaundice and gallbladder hydrops are unusual manifestations of Kawasaki disease (KD). In this case, abdominal pain, anorexia and abdominal distension may follow eventfully. We reviewed the clinical and laboratory data to investigate the causative factors of hyperbilirubinemia in patients with KD. Methods : Two-hundred eighty two children diagnosed and hospitalized with KD were identified by searching patients' charts....
The relation between angiotensin converting enzyme (ACE) gene polymorphism and neonatal hyperbilirubinemia in Korea
Mi Yeoun Kim, Jae Myoung Lee, Ji Sook Kim, Eun Ryoung Kim, Hee Jae Lee, Seo Hyun Yoon, Joo Ho Chung
Clin Exp Pediatr. 2007;50(1):28-32.   Published online January 15, 2007
Purpose : Human angiotensin converting enzyme (ACE) gene shows an insertion/deletion polymorphism in 16 intron, and three genotypes are determined by whether a 287 bp fragment of the DNA is present or not; II, ID and DD genotype. DD genotype has been suggested as a risk factor of chronic nephrotic disease such as IgA nephropathy and diabetic nephropathy, various cardiovascular...
Usefulness of the transcutaneous bilirubinometer during phototherapy in neonatal jaundice
Yung Kwun Lee, Kyung Ah Kim, Sun Young Ko, Yeon Kyung Lee, Son Moon Shin
Clin Exp Pediatr. 2006;49(12):1296-1300.   Published online December 15, 2006
Purpose : We studied the usefulness of transcutaneous bilirubinometers in follow-up of bilirubin levels during phototherapy in neonatal jaundice patients. Methods : Transcutaneous bilirubin (TcB) was measured twice per day on 90 neonatal jaundice patients without risk factors of jaundice by transcutaneous bilirubinometer JM-103(Minolta/Hill-Rom Air-shields, Japan). TcB was measured simultaneously on the patched-forehead (TcB-PF), patched- chest(TcB-PC), unpatched-forehead (TcB-UF) and unpatched-chest (TcB-UC)...
1828G>A polymorphism of the UDP-glucuronosyltransferase gene (UGT1A1) for neonatal hyperbilirubinemia in Koreans
Ja Young Kim, Mi Yeoun Kim, Ji Sook Kim, Eun Ryoung Kim, Seo Hyun Yoon, Hee Jae Lee, Joo Ho Chung
Clin Exp Pediatr. 2006;49(1):34-39.   Published online January 15, 2006
Purpose : The incidence of neonatal hyperbilirubinemia is twice as high in East Asians as in Caucasians. However, its metabolic basis has not been clearly explained. The UDP-glucuronosyltransferase gene(UGT1A1) mutation was found to be a risk factor of neonatal hyperbilirubinemia. We studied whether neonatal hyperbilirubinemia is associated with the 1828G>A(rs 10929303) polymorphism of the UGT1A1 gene, which encodes for a...
Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn
Jong Hee Hwang, Ji Hyun Lee, Yu Jin Kim, Su Hyun Koo, Jang Hun Lee, Chang Won Cho, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(10):1102-1106.   Published online October 15, 2005
Purpose : The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. Methods : Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants...
Near-Infrared Spectroscopy for Monitoring Cerebral Hemodynamics in Hyperbilirubinemia-induced Newborn Piglets
Jong Hee Hwang, Chang Won Choi, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(6):649-654.   Published online June 15, 2005
Purpose : The present study examined how changes in cerebral hemodynamics in newborn piglets with bilirubin infusion can be evaluated by near infrared sepctroscopy(NIRS). Methods : Seventeen newborn piglets were randomly divided into the following three experimental groups : six in the control group(CG); seven in the bilirubin infusion group(BG), and four in the bilirubin infusion with 7-nitroindazole group(NG). To...
The Association of Neonatal Hyperbilirubinemia with UGT1A1 and CYP1A2 Gene Polymorphism in Korean Neonates
Hoon Kang, Jun Ho Lim, Ji Sook Kim, Eun Ryoung Kim, Sung Do Kim, Hee Jae Lee, Joo Ho Chung
Clin Exp Pediatr. 2005;48(4):380-386.   Published online April 15, 2005
Purpose : The incidence of nonphysiologic neonatal hyperbilirubinemia is twice as high in East Asians as in whites. Recently, UGT1A1 mutation was found to be a risk factor for neonatal hyperbilirubinemia. In congenitally-jaundiced Gunn rats, which lack expression of UDP-glucuronosyltransferase, alternative pathways can be stimulated by inducers of CYP1A1 and CYP1A2 enzymes. CYP1A2 plays a major role in bilirubin degradation...
Usefulness of the Transcutaneous Bilirubinometer in Neonatal Jaundice
Joo Ran An, Sung Won Park, Hee Chul Lee, Kyung Ah Kim, Sun Young Ko, Yeon Kyung Lee, Son Moon Shin
Clin Exp Pediatr. 2004;47(12):1287-1292.   Published online December 15, 2004
Purpose : To test the usefulness of a new jaundice meter, the JM-103(Minolta/Hill-Rom Air-shields, Japan) which uses a new probe to compensate for different skin pigmentation or thickness, and displayed actual bilirubin level instead of an index number as in the previous model, the JM-102, we compared transcutaneous bilirubin(TCB) with plasma bilirubin(PB) in newborn infants. Methods : TCB was measured on...
Case Report
Two Cases of Rotor Syndrome in Siblings
Hwa-Jin Park, Eun-Sung Kim, Ji-Young Chung, Sung-Ho Cha, Deog-Yoon Kim
Clin Exp Pediatr. 2004;47(8):892-895.   Published online August 15, 2004
Rotor syndrome is a rare benign familial disorder characterized by chronic, fluctuating, nonhemolytic and predominantly direct bilirubinemia with normal liver tissue. We have recently experienced two cases of Rotor syndrome in a brother and sister. They revealed icteric sclerae with mild hepatomegaly in physical examination. Laboratory findings showed increased serum bilirubin with direct bilirubin predominance. The urinary excretion of total...
Original Article
Polymorphism of UDP-glucuronosyltransferase Gene(UGT1A1) of Neonatal Hyperbilirubinemia in Korea
Ki Woong Hong, Hoon Kang, Soo Kim, Ji Sook Kim, Eun Ryoung Kim, Hee Jae Lee, Sheng-Yu Jin, Joo Ho Chung
Clin Exp Pediatr. 2004;47(1):18-23.   Published online January 15, 2004
Purpose : The incidence of neonatal hyperbilirubinemia is twice as high in East Asians as in whites and its metabolic basis has not been clearly explained. Recently, UDP-glucuronosyltransferase gene (UGT1A1) mutation was found to be a risk factor of neonatal hyperbilirubinemia in Japanese and Taiwanese Chinese. We studied whether neonatal hyperbilirubinemia is associated with mutation of UGT1A1, which is a...
Diurnal Variation in Serum Bilirubin Concentration of Normal Newborn Infant
Cheol Am Kim, Jin Geong Jeong, Eui Tak Oh, Hong Ja Gang, Gil Seu Kim
Clin Exp Pediatr. 1998;41(1):33-37.   Published online January 15, 1998
Purpose : We investigated whether there are independent intradaily changes in bilirubin levels in normal neonates. Methods : During the period of January 1996 till July 1996, 100 healthy newborn infants were studied for at least 3 consecutive days. Starting from the third day of life, consistent intradaily changes of bilirubin concentration were observed. And obstetric history, birth history, weight change at 3 days were...
Oral Agar and Conventional Phototherapy Combination in the Treament of Neonatal Hyperbilirubinemia
Seong Wha Kim, Ji Hyang Doh, Jin Woo Choi, Min Hyang Kim, Ji Won Lee, Sung Taek Kim
Clin Exp Pediatr. 1997;40(7):931-938.   Published online July 15, 1997
Purpose : Neonatal jaundice is one of the most common problems in our country leading to hospitalization. Agar is low cost, low risk, and easily fed orally; it can bind bilirubin in the intestine, decreasing its enterohepatic circulation, thereby decreasing serum bilirubin levels. At present, however, the effectiveness of agar in the prevention and treament of neonatal jaundice is quite conflicting and controversy. Recently we...
Comparison of The Efficacy of the Fiberoptic Phototherapy and Conventional Phototherapy for Neonatal Hyperbilirubinemia
Hye Jung Min, Gwi Sook Kim, Soo Kyung Lee, Il Kyung Kim, Ho Sung, Chang Hee Choi
Clin Exp Pediatr. 1996;39(8):1076-1083.   Published online August 15, 1996
Purpose : We performed this study in order to compare the feasibility and efficacy of the fiberoptic phototherapy with conventional phototherapy and double phototherapy with single phototherapy for the treatment of neonatal hyperbilirubinemia while watching for any possible side effects of the system. Methods : During the period of February 1994 till June 1995, randomized controlled study was performed. 130 healthy term infants with non-hemolytic...
Riboflavin Status of Normal Newborn Infants and the Changes of Riboflavin During Phototherapy in Hyperbilirubinemic Newborn Newborn Infants
Eun Ae Park, Gyoung Hee Kim
Clin Exp Pediatr. 1995;38(9):1185-1192.   Published online September 15, 1995
Purpose : Riboflavin is the most important water soluble vitamin in infant nutrition. Riboflavin is converts to flavin mononucleotide (FMN), Flavin adenine dinucleotide(FAD) and then, participiates in the metabolism of energy, protein cellular oxidation-reduction reactions as a cofactor of reactions. Also riboflavin, a light sensitive vitamin, has a maximum absorption spectrum at a wave length similar to that at which...
A Study of Auditory Brainstem Responses in Neonates with Hyperbilirubinemia and Their Neurodevelopmental Outcome
Sung Shin Park, Myoung Jae Chey, Kil Hyun Kim, Hak Soo Lee
Clin Exp Pediatr. 1995;38(1):1-9.   Published online January 15, 1995
Neonatal hyperbilirubinemia is a significant risk factor for the developemtn of otoneurologic disorder. Hyperbilirubinemia resulting in kernicterus produces widespread neuronal damage with the most common sites of staining and destruction involving the hippocampus, basal ganglia and the brainstem nuclei in the floor of the fourth ventricle, including the dorsal cochlear nucleus. ABR may be a useful tool for the monitoring early...
A Clinical Observation of Neonatal Hyperbilirubinemia Due to ABO imcompatibility
Kang Woo Lee, Young Guk Kim, Dong Gun Park, Kee Hwan Yoo, Kwang Chul Lee, Soon Kyum Kim
Clin Exp Pediatr. 1994;37(1):54-60.   Published online January 15, 1994
A clinical and statistical study was performed on 213 neonates of hyperbilirubinemia who were admitted to department of pediatrics of Korea University Hospital from Jan. 1989 to Jun. 1991. And we studied the difference between ABO compatible group and incompatible group, such as, day of appe5rance of hyperbilirubinemia, tendency of bilirubin concentration change, reticulocyte, hemoglobin and duration of hyperbilirubinemia. The following...
High-Dose Intravenous Immune Globulin Therapy for Hyperbilirubinemia Caused by ABO Incompatibility
Dong Sung Kim, Dong Un Kim, Ji Whan Han, Sung Soo Whang, Kyung Yil Lee, Man Kyu Yang
Clin Exp Pediatr. 1993;36(8):1073-1079.   Published online August 15, 1993
Four newborn infants with hyperbilirubinemia, caused by ABO blood group incompatibility, were treated with high-dose intravenous immune globulin (IVIG). As soon as the diagnosis was clinically suspected, these infants received conventional treatment including phototherapy and were monitored closely for bilirubin levels. When bilirubin concentrations reached the risk point in spite of pjototherapy, IVIG was given at a dose of 1g/kg for...
The Effect of Phototherapy on Serum bilirubin Binding Capacity and Affinity in the Neonate.
In Suck Ryu, Chul Lee, Ran Namkung, Dong Gwan Han
Clin Exp Pediatr. 1990;33(10):1319-1325.   Published online October 31, 1990
Since the effect of phototherapy in the treatment of neonatal hyperbilirubinemia has been reported 30 years ago, phototherapy has been used widely for neonatal hyperbilirubinemia, but the exact mechanism and the effect of light on the human body have not been fully determined. Free bilirubin level in the serum is an important indicator for kemicterus, a complication of neonatal hyperbilirubinemia. Free bilirubin level was...
Changes in Auditory Brainstem Reponses (ABR) in Severe Hyperbilirubinemic Neonates with Transient Bilirubin Encephalopathy.
Chong Woo Bae, Sa Jun Chung, Chang Il Ahn
Clin Exp Pediatr. 1990;33(9):1216-1222.   Published online September 30, 1990
Many authors have reported alterations in the ABR in severe hyperbilirubinemia and ABR is an effective non-invasive method of assessing the functional status of the auditory nerve and brainstem sensory pathway in the management of neonatal hyperbilirubinemia. Perlman et al reported that jaundice in the early neonatal period is associated with significant transient aberration of ABR, suggestive of a transient bilirubin encephalopathy (TBE). And...
A Clinical Observation of Neonatal Hyperbilirubinemia due to ABO Incompatibility.
Mi Jung Koh, Young Kyun Lee, Jin Hong Park, Yeon Kyun OH
Clin Exp Pediatr. 1990;33(9):1194-1201.   Published online September 30, 1990
A clinical and statistical study was performed on 43 neonates of hyperbilirubinemia due to ABO incompatibility who were admitted to department of pediatrics of Won-kwang University hospital from May 1987 to June 1988. The following results were obtained: 1) The incidence of hyperbilirubinemia within 48 hrs were 30.3% in the incompatible group and 10. 2% in the compatible group. So, hyperbilirubinemia was appeared earlier in...
Measurement of Carboxyhemoglobin in the Newborns with ABO Incompatible Hyperbilirubinemia.
Jung Ae Shin, Son Moon Shin, Jeong Ok Hah, Chun Dong Kim
Clin Exp Pediatr. 1990;33(9):1188-1193.   Published online September 30, 1990
To develop more reliable screening test for ABO incompatible hemolytic disease than commonly employed and to identify possible indicators of severity of hyperbilirubinemia, a pilot study was performed by measuring the carboxyhemoglobin (HbCO) of the newborn babies within 48 hours after birth. Forty eight newborn babies were studied and carboxyhemoglobin was measured by spectro- photometry and serum bilirubin was measured by Diazo coupling method. There...
Two Case of Transient Bilirubin Encephalopathy in Newborn.
Eun Kyoung Sohn, Chong Woo Bae, Sa Jun Chung, Chang Il Ahn
Clin Exp Pediatr. 1989;32(9):1295-1299.   Published online September 30, 1989
More recently, several studies have been repotted about the abnormalities of auditory brainstem response (ABR) in hyperbilirubinemia of newborn. By using of ABR, visual evoked potenital and nuclear magnetic resonance techniques, some investigators suggested that transient alteration in ABR in severely jaundiced neonates indicated reversible transient subclinical or clinical bilirubin induced neurotoxicity. They thought it would be the early stage of kernicterus. We experienced two...
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