MLB Weekly Digest September 3rd Edition - NGSC Sports
Jaundice To Liver Fibrosis: Here Are Some Serious Consequences Of High Bilirubin
High bilirubin levels, a condition known as hyperbilirubinemia, can have significant consequences on human health. Bilirubin is a leftover product created by the liver during the breakdown of red blood cells. Normally, it is processed by the liver and excreted in bile, which is then eliminated from the body through faeces. As per WebMd normal total bilirubin levels in persons over the age of 18 can reach 1.2 milligrammes per deciliter (mg/dl) of blood. The typical amount for those below the age of 18 is 1 mg/dl.
However, when bilirubin levels become elevated, it can lead to a range of health consequences.
JaundiceOne of the primary consequences of high bilirubin levels is jaundice, a condition characterised by the yellowing of the skin and eyes. Jaundice is often the first noticeable sign of high bilirubin level.
hyperbilirubinemia and can result from various underlying causes, such as liver disease, hepatitis, or hemolytic anaemia. A study published in the Journal of Clinical and Experimental Hepatology (2019) found that jaundice due to hyperbilirubinemia can impact the quality of life of affected individuals, leading to physical discomfort, fatigue, and psychological distress.
Effect On Central Nervous SystemHigh bilirubin levels can also have detrimental effects on the central nervous system (CNS). Bilirubin has been shown to cross the blood-brain barrier and accumulate in brain tissues, leading to a condition called bilirubin encephalopathy or kernicterus. Kernicterus is a rare but serious condition that can cause permanent neurological damage, especially in newborns with immature liver function. A review article published in the journal Seminars in Fetal and Neonatal Medicine (2018) highlighted that untreated hyperbilirubinemia in newborns can result in long-term consequences, including hearing loss, movement disorders, and developmental delays.
Also read: What Causes Yellow Eyes or Jaundice Eyes? Know All About This Eye Condition
Cardiovascular DiseaseHigh bilirubin levels have been linked to an increased risk of cardiovascular disease. A study published in the journal Atherosclerosis (2017) found that elevated bilirubin levels were associated with an increased risk of developing atherosclerosis, a condition characterized by the build-up of plaque in arteries, leading to reduced blood flow to vital organs. The study suggested that bilirubin may have a protective effect against atherosclerosis, as it acts as an antioxidant and has anti-inflammatory properties. However, when bilirubin levels are too high, it can potentially lead to adverse effects on cardiovascular health.
Increased levels of high bilirubin can impact liver function and lead to liver damage. A study published in the Journal of Hepatology (2016) found that elevated bilirubin levels were associated with an increased risk of liver fibrosis, which is the formation of scar tissue in the liver. Liver fibrosis can progress to cirrhosis, a severe form of liver disease that can have life-threatening consequences. The study suggested that bilirubin levels may be a potential marker for liver fibrosis progression and can help identify individuals at risk for liver-related complications.
Moreover, high bilirubin levels have been associated with an increased risk of neonatal mortality. According to a study published in the journal Pediatrics (2014), elevated bilirubin levels in newborns were associated with an increased risk of death, particularly in premature infants. The study highlighted the importance of monitoring bilirubin levels in newborns and implementing appropriate interventions to prevent the detrimental consequences of hyperbilirubinemia.
Also read: Doctor Debunks Common Jaundice Myths and Facts
TakeawayIf the level of bilirubin increases abnormally then it can have significant consequences on human health. Scientific research published in various journals has shown that hyperbilirubinemia can result in jaundice, neurological damage, increased cardiovascular risk, liver damage and neonatal mortality. Timely detection and management of elevated bilirubin levels are crucial to prevent these adverse effects. It is important to seek advice from healthcare providers in order to know about the consequences of high bilirubin.
Understanding Newborn Jaundice
Newborn jaundice is when a baby's skin and eyes turn yellow from too much bilirubin. It usually resolves as their liver matures and they start feeding, but if it persists, there may be another cause.
In most cases, jaundice (also called hyperbilirubinemia) in newborns will disappear within 2 to 3 weeks.
The higher the bilirubin levels are, the more the baby is at risk for brain damage.
Bilirubin is a yellow pigment produced during the typical breakdown of red blood cells. In older babies and adults, the liver processes bilirubin, passing it through the intestinal tract. However, a newborn's still-developing liver may not be mature enough to do this.
There are two types of newborn jaundice: physiological and pathological.
Physiological jaundice is the most common, accounting for 75% of cases. This just means the baby's metabolism cannot clear out bilirubin as quickly as it is produced. This type typically develops in a few days and clears up on its own in a few weeks when the breakdown of red blood cells slows and liver function improves.
On the other hand, pathological jaundice means that there is another underlying condition that's causing a problem with filtering out bilirubin. This type may show up in the first 24 hours after birth.
Possible causes include:
Pathological jaundice can also be caused by certain medications, such as certain antibiotics.
The first sign of jaundice is the yellowing of a baby's skin and eyes, which may start in the face before spreading across the body. With physiological jaundice, the yellowing may begin and peak within 2 to 5 days after birth. With other causes, it may begin closer to birth.
However, this yellowing can be harder to see in darker skin tones. Another way to tell is by pressing your finger lightly on the baby's skin. The spot should briefly appear paler. If it looks more yellow, it's likely a sign of jaundice.
If you have concerns or are unsure, contact your baby's doctor, particularly if the whites of their eyes look yellow.
If untreated, severe newborn jaundiced can lead to acute bilirubin encephalopathy, which is caused by the toxic levels of bilirubin in the brain.
A baby may get a fever, act listless and lethargic, have a shrill cry, refuse to feed, and curve their neck and body backward. This can, in turn, progress to kernicterus, which is permanent brain damage.
In the United States, many hospitals discharge birthing parents and newborns after 24-48 hours before jaundice may become very apparent. If the baby has not developed jaundice within 72 hours of delivery, they're less likely to have the pathological form. But they can still develop the physiological form, leading to complications.
Once you're home, contact your doctor if you notice the following symptoms:
There are some things that can increase the chance of a newborn developing physiological jaundice.
These include:
In addition, certain risk factors can increase your baby's chance of developing severe jaundice, which may be physiological or pathological. These include:
Though distinct yellow coloring confirms that a baby has jaundice, additional tests may be needed to determine the severity.
Babies who develop jaundice will get a bilirubin blood test to determine the levels of bilirubin in their blood.
Additional tests may be needed to see if a baby's jaundice is due to an underlying condition. This may include testing your baby for their complete blood count (CBC), blood type, and Rh incompatibility.
Additionally, a Coombs test may be done to check for antibodies that show an elevated risk of increased red cell breakdown (hemolysis).
Mild jaundice will usually resolve on its own as a baby's liver matures. Frequent feedings (at least 8 times a day) will help babies pass bilirubin through their bodies.
More severe jaundice may require other treatments. Phototherapy (light therapy) is a common and highly effective method of treatment that uses light to break down bilirubin in your baby's body.
In phototherapy, your baby will be placed on a special bed under a blue spectrum light while wearing only a diaper and special protective goggles. A fiber-optic blanket may also be placed underneath your baby.
In very severe cases, an exchange transfusion may be necessary. In this procedure, a baby receives small amounts of blood from a donor or a blood bank.
This replaces the baby's damaged blood with healthy red blood cells. This also increases the baby's red blood cell count and reduces bilirubin levels.
In addition, if there's an underlying cause, the baby will need to be treated for the condition to resolve symptoms.
Physiological jaundice can't be prevented. But you can reduce the chance of development by frequently feeding your newborn, which can help their bilirubin pass through the body more quickly.
If you or your doctor thinks there is a likely underlying issue that could cause jaundice in your newborn, there are tests that can verify this so that you or the baby can get preventive treatment if appropriate.
For example, during pregnancy, you can have your blood type tested to rule out the possibility of Rh incompatibility. If you're Rh-negative, you can get intravenous immunoglobulin during pregnancy.
What does jaundice poop look like?Newborns that develop jaundice can have a pale-colored stool, but not often. Most newborns with jaundice will have the same color stool as newborns without jaundice. It may begin as black, dark brown, or dark green in the first few days, and then transition to yellow or orange-colored stool. For this reason, it can be hard to recognize jaundice from the stool color alone.
What color is jaundice pee in newborns?A newborn with jaundice may have dark yellow urine. As you feed the baby, it should become colorless. Make sure your baby is having at least six diapers daily.
What do babies' eyes look like with jaundice?In addition to the yellowing of the skin, jaundice also causes the yellowing of the white part of the eyes.
Most cases of physiological newborn jaundice will clear away, often without treatment. Frequent feedings will help it resolve. But your doctor will still monitor your baby to make sure it is improving.
The outlook of pathological jaundice depends on the underlying cause and what treatment the baby requires. In both cases, without immediate treatment, complications can begin to develop.
The most recent guidelines by the American Academy of Pediatrics (AAP) recommend that all newborn babies be examined for jaundice at least every 12 hours after birth and until their discharge from the hospital
Low Bilirubin: What It Means
Bilirubin is a yellowish pigment produced when hemoglobin in your red blood cells breaks down. Once it breaks down, it's sent through your liver, gallbladder, and bile ducts before being excreted.
Your doctor may order a bilirubin test as part of a typical comprehensive metabolic panel or liver panel. A liver panel may include liver function tests and total protein tests. Your doctor might also order a bilirubin test if you have certain symptoms.
Usually, bilirubin levels hover somewhere between 0.3 to 1.2 milligrams per deciliter (mg/dL). Read on to learn more about bilirubin and what levels below this range could mean.
If you're looking at your test results, you'll probably notice a few kinds of bilirubin, including:
Your doctor might say you have low bilirubin levels if any of these are outside of the usual range.
Low bilirubin levels usually don't cause any symptoms and aren't usually a cause for concern. Most people don't even know they have low bilirubin levels until their doctor orders a blood test.
If you have low bilirubin levels and notice any unusual symptoms, make an appointment with your doctor. You may have an unrelated condition that needs treatment.
There aren't any health conditions that cause low bilirubin levels. But consuming certain substances can temporarily lower them.
These include:
Consuming any of these a few hours before a blood test can make your bilirubin levels appear low in your test results.
To avoid this, don't take any of these substances for at least eight hours before a blood test. Your doctor might also give you additional instructions on other things to avoid before the test for accurate results.
There's no clear link between low bilirubin levels and any medical conditions. However, some research suggests that bilirubin acts as an antioxidant. Antioxidants protect tissues throughout your body from damage by substances that can cause cells to break down.
Based on bilirubin's potential antioxidant properties, some believe that not having enough of it can leave certain body parts vulnerable to damage.
This damage could potentially lead to a range of conditions, such as:
Brain lesionsA 2018 study suggests that low bilirubin levels could increase your risk of developing deep white matter lesions in your brain, even if you don't have any other health issues. These lesions are linked to several conditions, including dementia and heart disease.
StrokesLow bilirubin levels may also be associated with blood vessel damage, according to a 2009 study.
This type of damage can increase your risk of having a stroke. The study notes that women are less likely to have a stroke related to low bilirubin levels.
Eye diseaseA 2017 study found that low bilirubin levels may be a marker for diabetic retinopathy. This is an eye condition that happens when blood vessels near the retina at the back of the eye are damaged.
Keep in mind that much more research is needed before experts can draw any concrete links between bilirubin levels and someone's risk of developing these conditions.
While high bilirubin levels can indicate several health issues, low bilirubin levels usually aren't anything to worry about. In some cases, it could be a side effect of a medication you take or having too much coffee before your blood test.
While low bilirubin levels may be associated with certain conditions, this link still isn't totally clear.
If your test results show you have low bilirubin levels, your doctor will likely just keep an eye out for any other symptoms you have and run another test after some time has passed.
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