Kernicterus

What is Kernicterus?

"If your baby has kernicterus, you may have a medical malpractice claim against healthcare providers who caused this injury. The malpractice claim is for the harm your child has suffered, and for the cost of care and treatment for your child.”
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Kernicterus is a rare but serious disease that affects babies soon after they are born. It is especially tragic because it is easily prevented. The first indication of the disease is the yellowing of a baby’s skin, called jaundice. Jaundice is caused by an excess of bilirubin in a baby’s system. If jaundice is treated, kernicterus can be prevented. Kernicterus only develops if jaundice and bilirubin toxicity are left untreated.

Children who develop kernicterus are likely victims of medical malpractice. While some children who have kernicterus can ultimately do well, others may have severe problems that will require a lifetime of care

Background Information

Bilirubin is a yellow chemical produced in the blood from the normal breakdown of red blood cells (red corpuscles or erythrocytes) in a process call hemolysis. Bilirubin travels to the liver, where a chemical reaction takes place to remove it from the blood. Sometimes, however, the liver cannot remove enough bilirubin and the amount of bilirubin in the blood increases. This extra bilirubin travels to all parts of the body through the bloodstream, causing the skin to turn yellow. Again, the medical term for this yellow skin color is jaundice. The medical term for the extra bilirubin in the blood is hyperbilirubinemia.

Besides causing the skin to turn yellow, the bilirubin can cause damage to a baby’s brain. This happens when excessive bilirubin remains in the body for too long. The yellow color of the skin is the clue that there is a problem and that treatment is required, so that kernicterus can be avoided. It is worth noting that according to Virginia Commonwealth University, almost sixty percent (60%) of babies are born jaundiced, while only the condition of a very small number worsens to kernicterus.

What is Kernicterus?

Kernicterus is the name given the disease in which too much bilirubin in the blood causes damage to the brain. The name kernicterus comes from two Greek words: “kern,” which refers to a portion of the brain, and “icterus,” which means yellow.

The brain is the part of the body most severely damaged by prolonged exposure to extra bilirubin in the blood. The parts of the brain most commonly affected are the basal ganglia (the kernel), and more specifically the globus pallidus, which is part of the basal ganglia. Severe damage to the brain can result in the child’s death. If the baby lives, he or she may experience deficits such as cerebral palsy, mental retardation and/or problems with vision and hearing (particularly, auditory neuropathy).

What are some warning signs of Kernicterus?

The most common sign that a baby is at risk for kernicterus is yellowing of the skin, especially in the first 24 hours after birth. Sometimes, the whites of the baby’s eyes (sclera) may turn yellow too. Other signs are extreme lethargy; the baby is not alert, difficult to wake up or can’t be kept awake.

Babies with kernicterus often have a shrill, high-pitched cry and may appear weak, limp, or floppy (hypotonic). Sometimes they lie unnaturally in bed with their bodies arching or bowing upward when lying on their backs (in positions known as opisthotonus or retrocollis).

Additionally, abnormal white spotting of the teeth, called dental enamel hypoplasia, may also be seen in sufferers of kernicterus.

Tests like the Bhutani Nomogram may be used to determine how much bilirubin is present in an infant’s system.

Does jaundice always lead to Kernicterus?

No. Many babies have jaundice when they are a few days old, but with proper treatment, it almost always goes away. Early diagnosis and treatment is the key to avoiding brain damage.

Are some newborn babies more likely to become Jaundiced than others?

Yes. Newborn babies more likely to develop jaundice than others include those who suffered a bruise during childbirth, those born early (prematurely), those who are not nursing well, those who have a brother or sister that had jaundice, and those born to an African-American, East Asian, or Mediterranean family in whom G6PD (Glucose-6-Phosphate Dehydrogenase) deficiency is common.

The medication co-trimoxazole (a combination of trimethoprim/sulfamethoxazole) may also contribute to the development of the disorder. Kernicterus can also come about as a symptom of Crigler-Najjar syndrome.

Can Jaundice be treated so that Kernicterus will not develop?

Absolutely. Many times, jaundice will go away without treatment. However, if treatment is required, the main treatment is a simple one. Babies are placed under special blue lights for a number of hours, or wrapped in a “bili-blanket”. This is called phototherapy. It helps remove the bilirubin from the blood, which can cause kernicterus. The blue lights are warm and do not cause any harm to the baby.

If the baby gets very, very jaundiced, the doctor can do a blood transfusion to remove the extra bilirubin. This is called an “exchange transfusion.”

No baby should develop brain damage from untreated jaundice. Medical experts now refer to kernicterus as a “never event.”

Another danger of kernicterus is misdiagnosis. The brain damage caused by this disorder mimics some of the movement and language processing problems like autism spectrum disorders, mental retardation, and cerebral palsy.

What should I do if I think my baby has Jaundice?

You should contact your baby’s doctor and arrange for a visit.

If I have a child with Kernicterus, what can I do?

If your baby has kernicterus, you may have a medical malpractice claim against healthcare providers who caused this injury. The malpractice claim is for the harm your child has suffered, and for the cost of care and treatment for your child.
For a no-obligation telephone consultation to determine whether your child has a medical malpractice claim for kernicterus,
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Our lawyers are pursuing medical malpractice claims for children with kernicterus. The lawsuits filed on behalf of kernicterus patients and families seek damages for medical bills, loss of earning potential, pain and suffering, and loss of the pleasures of life. A $5 million settlement was recently won by our lawyers on behalf of a family with a baby with kernicterus who was not diagnosed properly.

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