Bronze baby syndrome

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Bronze baby syndrome (BBS) is a rare side effect of phototherapy for neonatal jaundice. The exact mechanism of discoloration is not yet known.

In 1972, physicians Arthur E. Kopelman, Ralph S. Brown, and Gerard B. Odell first described the phenomenon in the literature. [1]

BBS occurs when a neonate receiving phototherapy for neonatal jaundice also has a component of direct hyperbilirubinemia. The combination of direct hyperbilirubinemia and phototherapy causes a distinctive bronze/grey discoloration of the skin of the infant. This discoloration of the skin cells is permanent through the life of the cells, so it can take 3-4 weeks to resolve, as the new skin cells made will not have the discoloration. [2]

This discoloration is not overall harmful to the infant, but it is cosmetically concerning to parents and it is hypothesized that it could interfere with transcutaneous monitoring of infants, like pulse oximetry and transcutaneous carbon dioxide monitors used in intensive care, but that effect is not fully studied yet, since the effect is so rare. [3]

Development of BBS is an indication to consider proceeding to exchange transfusion for hyperbilirubinemia in the neonate, though some have reported successful continued treatment despite development of the condition. [4] [5] [3]

References

  1. ↑ The “bronze” baby syndrome: A complication of phototherapy Kopelman, Arthur E. et al. The Journal of Pediatrics, Volume 81, Issue 3, 466 - 472
  2. ↑ Kar, Sumit; Mohankar, Atul; Krishnan, Ajay (2013). "Bronze baby syndrome". Indian Pediatrics. 50 (6): 624. doi:10.1007/s13312-013-0161-6. ISSN   0019-6061. PMID   23942414.
  3. 1 2 Peinado-Acevedo, Juan Sebastián; Chacón-Valenzuela, Estephanía; Rodríguez-Moncada, Laura Liliana (2018). "[Bronze baby syndrome, an unpredictable complication of phototherapy: A case report]". Biomédica. 38: 15–18. doi:10.7705/biomedica.v38i0.3593. ISSN   2590-7379. PMID   29809326.
  4. ↑ Bronze Baby Syndrome Le, Thao-vy Ngoc et al. The Journal of Pediatrics, Volume 188, 301 - 301.e1
  5. ↑ Lee, Da Jeong; Song, Woo Sun; Kim, Seung Yeon (2019). "Gray-brown skin discoloration following phototherapy for hyperbilirubinemia due to anti-E alloimmunization". Korean Journal of Pediatrics. 62 (11): 428–430. doi:10.3345/kjp.2019.00528. ISSN   1738-1061. PMC   6881204 . PMID   31760722.


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