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A 4day old infant presents with yellow discolouration of the sclera and skin.the baby was born at term by a normal vaginal delivery.pregmancy was uncomplicated,no risk factor for sepsis,no history of maternal alcohol or drug use.
the baby is breastfed and has been nursing every 2hrs about 10mins at each breast.bilirubin level is 15mg/dl all unconjugated,hematocrit is 45%,coombs is negative.what is the most likely diagnosis.
a. Congenital biliary atresia
b. isoimmune hemolytic disease
c. criggler najjar syndrome
d. breast milk jaundice
e. breast feeding jaundice
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C. Crigler-Najjar syndrome ?
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C.. because all bilirubin is unconjugated, means there is total absence of enzyme.
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i like the way virgo answered question - if you can answer with an explanation that means you understand the concept.
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I think D...
Considering the fact that the baby is otherwise healthy, and is being breast fed every 2hrs for 10mins. I'ld expect Kernicterus S/S at 15mg/dl unconjugated bilirubin
