Makindo Medical Notes

Do not miss the diagnosis of biliary atresia

About

• Neonatal Jaundice: The onset of jaundice within the first 24 hours of birth is always assumed to be pathological.
• After 24 hrs physiological jaundice may be seen in the newborn resolves within 2 weeks and is mostly unconjugated.
• Biliary atresia causes jaundice which is mostly conjugated bilirubin. Severe unconjugated hyperbilirubinaemia may lead to kernicterus with bilirubin > 360 micromoles/L

TSB (Total Serum Bilirubin) is a blood test used to measure the level of bilirubin in a newborn's blood. Bilirubin is a yellow compound produced during the normal breakdown of red blood cells. Elevated levels of bilirubin can lead to jaundice, which causes the skin and the whites of the eyes to appear yellow.

Causes

Why is TSB Important?

• Newborns often have higher bilirubin levels due to the immaturity of their liver, which processes bilirubin for excretion.
• TSB levels help to determine the severity of jaundice and the need for treatment such as phototherapy or exchange transfusion.
• By monitoring TSB levels, healthcare providers can ensure that jaundice does not progress to more serious conditions such as kernicterus (a form of brain damage caused by very high bilirubin levels).

Normal TSB Levels in Newborns

• Normal TSB levels can vary depending on the baby's age (in hours), but jaundice typically becomes noticeable when bilirubin levels exceed 5 mg/dL.
• Levels higher than 20 mg/dL are concerning and may require immediate medical intervention.