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UZAMIŞ SARILIKLI İNFANTLARIN KLİNİK ÖZELLİKLERİ

Yıl 2020, Cilt: 21 Sayı: 1, 116 - 120, 20.03.2020
https://doi.org/10.18229/kocatepetip.618262

Öz

AMAÇ: Uzamış unkonjuge hiperbilirubinemi, bir neona-tal sarılık tipidir. Yenidoğanlarda, postnatal 14-21 günden daha uzun süren, yüksek bilirubin düzeyleri(<8 mgr/dl) ile karakterizedir. Bu çalışmada, uzamış sarılıklı bebek-lerin klinik ve laboratuvar bulgularını değerlendirdik ve altta yatan sebepleri ele aldık.

GEREÇ VE YÖNTEM: Bu prospektif çalışmaya, Ocak 2018-Aralık 2018 tarihleri arasında pediatri poliklinikle-rimizde uzamış unkonjuge hiperbilirubinemi tanısı alan yenidoğan bebekler dahil edildi. Hastaların demografik, klinik ve laboratuvar bulguları kaydedildi ve değerlendi-rildi.

BULGULAR: Toplamda, uzamış sarılık tanısı alan 91 be-bek ve kontrol grubu olarak 65 sağlıklı yenidoğan çalış-maya alındı. Uzamış sarılıklı bebeklerin, ortalama doğum kilosu 3152 ± 504 g (1800-4300 g), ortalama gestasyon yaşı 38.2 ± 1.6 hafta (35-41 hafta) ve tanı sırasındaki or-talama bilirubin düzeyleri 10.98 ± 2.3 mg/dL (8-18.7 mg/dL) olarak bulundu. Uzamış sarılıklı bebeklerde, erkek cinsiyet baskın bulundu (%61.5). Doğum kilosuna ulaşma zamanı, uzamış sarılıklı bebeklerde kontrol grubundan daha uzundu (p=0.02). Uzamış sarılığın altında yatan se-bepler şunlardı: %45 anne sütü, %9.9 konjenital hipotiro-idizm ve %4.4 idrar yolu enfeksiyonu.

SONUÇ: Yenidoğanlarda, uzamış sarılığın temel nedenle-rini tespit etmek, oldukça önemlidir. Çoğu olguda, yeni-doğan sarılığı anne sütü ile beslenme gibi fizyolojik fak-törlerle birliktedir.

Kaynakça

  • 1. Mackinlay GA. Jaundice persisting beyond 14 days after birth. BMJ 1993; 306: 1426-1427.
  • 2. Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neonatal jaundice. Acta Paediatr 2000; 89: 694-697.
  • 3. Schneider AP. 2nd. Breast milk jaundice in the newborn. A real entity. JAMA 1986; 255: 3270-3274.
  • 44. Agrawal V, Goyal AK, Sharma JN, Yadav MD. Different causes of prolonged unconjugated jaundice in the newborns. Int J Contemp Pediatr 2017; 4: 984-988.
  • 20. Arsan S, Koç E, Uluşahin N, Sönmezışık G. Yenidoğanda uzamış indirekt hiperbilirubineminin etiyolojik yönden incelenmesi. MN Klinik Bilimler 1995; 1: 14-18.
  • 6. Najib KS, Saki F, Hemmati F, Inaloo S. Incidence, risk factors and causes of severe neonatal hyperbilirubinemia in the south of Iran (Fars province). Iran Red Crescent Med J 2013; 15: 260-263.
  • 7. Andre M, Day AS. Causes of prolonged jaundice in infancy: 3-year experience in a tertiary paediatric centre. N Z Med J 2016; 129: 14-21.
  • 8. Sabzehei MK, Basiri B, Gohari Z, Bazmamoun H. Etiologies of prolonged unconjugated hyperbilirubinemia in neonates admitted to neonatal wards. Iranian Journal of Neonatology 2015; 6: 37-42.
  • 9. Preer GL, Philipp BL. Understanding and managing breast milk jaundice. Arch Dis Child Fetal Neonatal Ed 2011; 96: F461-F466.
  • 10. Gourley GR. Pathophysiology of breast-milk jaundice. In: Polin RA, Fox WW (eds) Fetal and Neonatal Physiology, 2nd Ed. WB Saunders Company, Philadelphia. 1998: pp 1499–1505
  • 11. Arias IM, Gartner LM, Seifter S, Furman M. Prolonged neonatal unconjugated hyperbilirubinemia associated with breast feeding and a steroid, pregnane-3(alpha), 20(beta)-diol in maternal milk that inhibits glucuronide formation in vitro. J Clin Invest 1964; 43: 2037-2047.
  • 12. Poland, RL, Schultz GE, Gayatri G. High milk lipase activity associated with breastmilk jaundice. Pediatr Res 1980; 14: 1328-1331.
  • 13. Agarwal R, Deorari AK. Unconjugated hyperbilirubinemia in newborns: current perspective. Indian Pediatr 2002; 39: 30-42.
  • 14. Yordam N, Calikoğlu AS, Hatun S, et al. Screening for congenital hypothyroidism in Turkey. Eur J Pediatr 1995; 154: 614-6.
  • 15. Çetinkaya M, Özkan H. The Distribution of Etiology in Newborns with Prolonged Jaundice. J Curr Pediatr 2008; 6: 99-103.
  • 16. Wong RJ, De Sandre GH, Sibley E, Stevenson DK. Neonatal jaundice and liver disease. In: Fanarof AA, Martin RJ (eds). Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 2006: 1419-66.
  • 17. Koç F, Koturoğlu G, Akşit S, Kurugöl Z. Uzamış sarılıklı bebeklerin değerlendirilmesi. Ege Pediatri Bülteni 2008; 15: 89-92.
  • 18. Bilgen H, Ozek E, Unver T, Biyikli N, Alpay H, Cebeci D. Urinary tract infection and hyperbilirubinemia. Turk J Pediatr 2006; 48: 51-55.
  • 19. Sivaslı E. Prolonged jaundice in newborn babies. Gaziantep Medical Journal 2009; 15: 49-55.
  • 21. Tuygun N, Tıraş Ü, Şıklar Z, Erdeve Ö, Tanyer G, Dallar Y. Yenidoğan uzamış sarılığının etiyolojik yönden değerlendirilmesi ve anne sütü sarılığı. Türk Pediatri Ars 2002; 37: 138-143

CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE

Yıl 2020, Cilt: 21 Sayı: 1, 116 - 120, 20.03.2020
https://doi.org/10.18229/kocatepetip.618262

Öz

OBJECTIVE: Prolonged unconjugated hyperbilirubinemia is a type of neonatal jaundice, which occurs in newborns with high bilirubin levels (> 8 mg/dl) persisting beyond 14-21 postnatal days. This study was carried out to evaluate and determine the clinical and laboratory characteristics of infants with prolonged jaundice and underling causes.
MATERIAL AND METHODS: This prospective study was conducted on newborn infants diagnosed with prolonged unconjugated hyperbilirubinemia during January 2018 and December 2018 at our pediatric outpatient clinic. The demographic, clinical and laboratory characteristics of these patients were recorded and then analyzed.
RESULTS: In total, 91 infants diagnosed with prolonged jaundice and 65 healthy newborn infants as control group were enrolled in this study. Of the infants with prolonged jaundice, mean birth-weight was 3152 ± 504 g (1800-4300 g), mean gestational age was 38.2 ± 1.6 weeks (35-41 weeks), and mean total bilirubin level at the time of diagnosis was 10.98 ± 2.3 mg/dL (8-18.7 mg/dL). There was male sex dominance in prolonged jaundice group (61.5%) Time to reach birth-weight was longer in infants with prolonged jaundice than control group (p = 0.02). The underlying etiologies of prolonged jaundice were as follows: breast milk (45%), congenital hypothyroidism (9.9%) and urinary tract infection (4.4%).
CONCLUSIONS: Determining the main causes of prolonged jaundice in neonates is of paramount importance. In the majority of cases, neonatal hyperbilirubinemia is associated with physiological factors like breastfeeding

Kaynakça

  • 1. Mackinlay GA. Jaundice persisting beyond 14 days after birth. BMJ 1993; 306: 1426-1427.
  • 2. Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neonatal jaundice. Acta Paediatr 2000; 89: 694-697.
  • 3. Schneider AP. 2nd. Breast milk jaundice in the newborn. A real entity. JAMA 1986; 255: 3270-3274.
  • 44. Agrawal V, Goyal AK, Sharma JN, Yadav MD. Different causes of prolonged unconjugated jaundice in the newborns. Int J Contemp Pediatr 2017; 4: 984-988.
  • 20. Arsan S, Koç E, Uluşahin N, Sönmezışık G. Yenidoğanda uzamış indirekt hiperbilirubineminin etiyolojik yönden incelenmesi. MN Klinik Bilimler 1995; 1: 14-18.
  • 6. Najib KS, Saki F, Hemmati F, Inaloo S. Incidence, risk factors and causes of severe neonatal hyperbilirubinemia in the south of Iran (Fars province). Iran Red Crescent Med J 2013; 15: 260-263.
  • 7. Andre M, Day AS. Causes of prolonged jaundice in infancy: 3-year experience in a tertiary paediatric centre. N Z Med J 2016; 129: 14-21.
  • 8. Sabzehei MK, Basiri B, Gohari Z, Bazmamoun H. Etiologies of prolonged unconjugated hyperbilirubinemia in neonates admitted to neonatal wards. Iranian Journal of Neonatology 2015; 6: 37-42.
  • 9. Preer GL, Philipp BL. Understanding and managing breast milk jaundice. Arch Dis Child Fetal Neonatal Ed 2011; 96: F461-F466.
  • 10. Gourley GR. Pathophysiology of breast-milk jaundice. In: Polin RA, Fox WW (eds) Fetal and Neonatal Physiology, 2nd Ed. WB Saunders Company, Philadelphia. 1998: pp 1499–1505
  • 11. Arias IM, Gartner LM, Seifter S, Furman M. Prolonged neonatal unconjugated hyperbilirubinemia associated with breast feeding and a steroid, pregnane-3(alpha), 20(beta)-diol in maternal milk that inhibits glucuronide formation in vitro. J Clin Invest 1964; 43: 2037-2047.
  • 12. Poland, RL, Schultz GE, Gayatri G. High milk lipase activity associated with breastmilk jaundice. Pediatr Res 1980; 14: 1328-1331.
  • 13. Agarwal R, Deorari AK. Unconjugated hyperbilirubinemia in newborns: current perspective. Indian Pediatr 2002; 39: 30-42.
  • 14. Yordam N, Calikoğlu AS, Hatun S, et al. Screening for congenital hypothyroidism in Turkey. Eur J Pediatr 1995; 154: 614-6.
  • 15. Çetinkaya M, Özkan H. The Distribution of Etiology in Newborns with Prolonged Jaundice. J Curr Pediatr 2008; 6: 99-103.
  • 16. Wong RJ, De Sandre GH, Sibley E, Stevenson DK. Neonatal jaundice and liver disease. In: Fanarof AA, Martin RJ (eds). Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 2006: 1419-66.
  • 17. Koç F, Koturoğlu G, Akşit S, Kurugöl Z. Uzamış sarılıklı bebeklerin değerlendirilmesi. Ege Pediatri Bülteni 2008; 15: 89-92.
  • 18. Bilgen H, Ozek E, Unver T, Biyikli N, Alpay H, Cebeci D. Urinary tract infection and hyperbilirubinemia. Turk J Pediatr 2006; 48: 51-55.
  • 19. Sivaslı E. Prolonged jaundice in newborn babies. Gaziantep Medical Journal 2009; 15: 49-55.
  • 21. Tuygun N, Tıraş Ü, Şıklar Z, Erdeve Ö, Tanyer G, Dallar Y. Yenidoğan uzamış sarılığının etiyolojik yönden değerlendirilmesi ve anne sütü sarılığı. Türk Pediatri Ars 2002; 37: 138-143
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Hatice Topal Bu kişi benim 0000-0003-3226-0205

Yaşar Topal 0000-0002-7059-4823

Nilay Hakan 0000-0002-6575-7640

Esra Özer 0000-0003-2634-7136

Yayımlanma Tarihi 20 Mart 2020
Kabul Tarihi 14 Şubat 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 21 Sayı: 1

Kaynak Göster

APA Topal, H., Topal, Y., Hakan, N., Özer, E. (2020). CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE. Kocatepe Tıp Dergisi, 21(1), 116-120. https://doi.org/10.18229/kocatepetip.618262
AMA Topal H, Topal Y, Hakan N, Özer E. CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE. KTD. Mart 2020;21(1):116-120. doi:10.18229/kocatepetip.618262
Chicago Topal, Hatice, Yaşar Topal, Nilay Hakan, ve Esra Özer. “CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE”. Kocatepe Tıp Dergisi 21, sy. 1 (Mart 2020): 116-20. https://doi.org/10.18229/kocatepetip.618262.
EndNote Topal H, Topal Y, Hakan N, Özer E (01 Mart 2020) CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE. Kocatepe Tıp Dergisi 21 1 116–120.
IEEE H. Topal, Y. Topal, N. Hakan, ve E. Özer, “CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE”, KTD, c. 21, sy. 1, ss. 116–120, 2020, doi: 10.18229/kocatepetip.618262.
ISNAD Topal, Hatice vd. “CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE”. Kocatepe Tıp Dergisi 21/1 (Mart 2020), 116-120. https://doi.org/10.18229/kocatepetip.618262.
JAMA Topal H, Topal Y, Hakan N, Özer E. CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE. KTD. 2020;21:116–120.
MLA Topal, Hatice vd. “CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE”. Kocatepe Tıp Dergisi, c. 21, sy. 1, 2020, ss. 116-20, doi:10.18229/kocatepetip.618262.
Vancouver Topal H, Topal Y, Hakan N, Özer E. CLINICAL CHARACTERISTICS OF INFANTS WITH PROLONGED JAUNDICE. KTD. 2020;21(1):116-20.

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