Journal
CLINICS IN PERINATOLOGY
Volume 43, Issue 2, Pages 297-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.clp.2016.01.007
Keywords
Kernicterus; Excitotoxicity; Low-bilirubin kernicterus; Auditory neuropathy; Cerebellum; Hypoalbuminemia
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Funding
- Mario Lemieux Foundation
- 25 Club of Magee-Womens Hospital
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Bilirubin-induced neurotoxicity in preterm neonates remains a clinical concern. Multiple cellular and molecular cascades likely underlie bilirubin-induced neuronal injury, including plasma membrane perturbations, excitotoxicity, neuroinflammation, oxidative stress, and cell cycle arrest. Preterm newborns are particularly vulnerable secondary to central nervous system immaturity and concurrent adverse clinical conditions that may potentiate bilirubin toxicity. Acute bilirubin encephalopathy in preterm neonates may be subtle and manifest primarily as recurrent symptomatic apneic events. Low-bilirubin kernicterus continues to be reported in preterm neonates, and although multifactorial in nature, is often associated with marked hypoalbuminemia.
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