What is hemolytic jaundice

The birth of a baby in the family is a happy event that brings joy to the whole family. However, some babies develop health problems that worry their families shortly after birth. Among them, hemolytic jaundice is one of them. The children often have yellow complexion, poor spirits, cry frequently, and do not eat properly. As a parent, it really hurts to see it all. So what is hemolytic jaundice?

1. Concept

1. Neonatal hemolytic jaundice is mainly caused by the mother's production of antibodies against the fetus' blood. The antibodies enter the fetus' blood through the placenta, destroying the fetus's red blood cells and causing anemia in the fetus. Jaundice occurs after birth due to excessive bilirubin.

2. Symptoms

1. The sclera is often slightly yellow, and there is fever during acute attacks. The skin and mucous membranes are often noticeably pale.

2. No itching on the skin.

3. Enlarged spleen.

4. There are signs of vigorous bone marrow hyperplasia.

5. The total serum bilirubin is increased, generally not exceeding 85μmol/L, mainly due to the increase of indirect bilirubin.

6. The amount of urobilinogen in the urine increases but there is no bilirubin. In acute attacks, there is hemoglobinuria, which is soy sauce colored. In chronic hemolysis, the amount of hemosiderin in the urine increases, and the amount of urobilinogen excreted in the feces increases within 24 hours.

3. Causes

Any disease that can cause hemolysis can produce hemolytic jaundice, including congenital hemolytic anemia and acquired hemolytic anemia. The former include thalassemia (thalassemia), hereditary spherocytosis, etc.; the latter include autoimmune hemolytic anemia, neonatal hemolytic disease, etc.

IV. Hazards

Unlike the jaundice caused by normal physiological phenomena of newborns, severe jaundice at birth may lead to sequelae such as cerebral palsy and hearing impairment in young children.

5. Diagnosis

1. The levels of fecal bilinogen and urobilinogen increase.

2. Increased serum bilirubin shows an indirect reaction in the Van den Berg test.

3. The number of reticulocytes in the blood increases.

4. Increased serum iron levels.

5. The red blood cell system of the bone marrow proliferates vigorously.

6. Treatment

1. Light therapy

Exposing the baby to light with a wavelength of 440nm can reduce his serum bilirubin and prevent the occurrence of kernicterus. If kernicterus has already occurred, it can speed up recovery. After exposure to this light, bilirubin is photooxidized into a colorless substance and excreted from the body through urine and bile. This treatment is simple and easy and has certain efficacy.

2. Blood transfusion

If serum indirect bilirubin exceeds 20 mg/dL (342 μmol/L), exchange transfusion is required. Blood donors must first undergo a screening test for G6PD deficiency. Only those without G6PD deficiency can donate blood to avoid worsening of jaundice and jaundice after transfusion. Avoid blood donation from relatives. Patients with mild jaundice do not need blood transfusion.

1. Tips

Not all newborns with ABO blood type incompatibility will develop neonatal hemolytic jaundice. It is reported that the incidence of ABO blood incompatibility hemolytic disease in newborns is 11.9%, so parents don't need to worry too much.