Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • 20th Anniversary Special Edition
    • Topic/Program Collections
    • Blog
    • Questions from NeoReviews
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
    • NeoReviewsPlus
    • Board Review Study Guide
  • Multimedia
    • NeoReviews Video Library
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • 20th Anniversary Special Edition
    • Topic/Program Collections
    • Blog
    • Questions from NeoReviews
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
    • NeoReviewsPlus
    • Board Review Study Guide
  • Multimedia
    • NeoReviews Video Library
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
Index of Suspicion in the Nursery

Case 1: Severe Jaundice in a 2-day-old Term Neonate

Allison Lyle and Rodica Turcu
NeoReviews August 2019, 20 (8) e464-e467; DOI: https://doi.org/10.1542/neo.20-8-e464
Allison Lyle
*Department of Graduate Medical Education, Indiana University School of Medicine, Indianapolis, IN
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rodica Turcu
†Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Presentation

A 2-day-old, 2.68-kg term male neonate is brought to the emergency department with lethargy, poor feeding, and significant generalized jaundice. He was born via spontaneous vaginal delivery at home to a gravida 4, para 3 Amish woman under the supervision of a midwife, at an estimated gestational age of 39 weeks after an uncomplicated pregnancy with scant prenatal care. Jaundice was noticed 7 hours after birth. The neonate has only breastfed 5 to 6 times since birth, and passed a normal-colored stool at home. Prenatal laboratory findings are unavailable because of limited prenatal care. The mother’s blood type is AB, Rh negative. The mother’s obstetric history includes a previous miscarriage (4 years earlier), a previous stillbirth at 30 weeks’ gestation (3 years earlier), and a term pregnancy (2 years earlier). She had received Rho(D) immune globulin 3 weeks after the miscarriage, 2 weeks after the stillbirth delivery, and 2 weeks after the most recent pregnancy. The mother, father, and 2-year-old brother are reportedly healthy.

Review of systems at admission is significant for decreased activity, poor feeding, and generalized, intense yellow discoloration of the skin. The infant has no fever, vomiting, diarrhea, constipation, bloody stools, seizures, or hypertonia. Physical examination reveals a weak cry, lethargy, scleral icterus, soft liver edge 3 cm below the right costal margin, and significant generalized jaundice of the entire body. No dysmorphic features are appreciated.

Case Progression

Initial evaluation revealed a total serum bilirubin (TB) of 49.4 mg/dL (845 μmol/L), conjugated bilirubin of 42 mg/dL (718 μmol/L), unconjugated bilirubin of 10.7 mg/dL (183 μmol/L), reticulocyte count greater than 23, and hemoglobin of 12.6 g/dL (126 g/L). Urinalysis demonstrated dark brown urine. Serum aspartate aminotransferase (AST) was elevated at 239 U/L (4 μkat/L), serum alanine …

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

NeoReviews
Vol. 20, Issue 8
1 Aug 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
  • Complete Issue (PDF)
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Case 1: Severe Jaundice in a 2-day-old Term Neonate
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Case 1: Severe Jaundice in a 2-day-old Term Neonate
Allison Lyle, Rodica Turcu
NeoReviews Aug 2019, 20 (8) e464-e467; DOI: 10.1542/neo.20-8-e464

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Case 1: Severe Jaundice in a 2-day-old Term Neonate
Allison Lyle, Rodica Turcu
NeoReviews Aug 2019, 20 (8) e464-e467; DOI: 10.1542/neo.20-8-e464
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Presentation
    • Case Progression
    • Follow-up
    • Discussion
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Case 1: A Rare Presentation of Abdominal Distention in a Preterm Newborn
  • Case 3: What's That Smell? The Significance of Infant Body Odors in the Evaluation of Metabolic Acidosis
  • Case 2: Intergluteal Sulcus Flattening in a Newborn
Show more Index of Suspicion in the Nursery

Similar Articles

  • Journal Info
  • Editorial Board
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • NeoReviewsPlus
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
  • NeoReviews™ and NeoReviewsPlus™ are supported, in part, through an educational grant from Abbott Nutrition, a division of Abbott Laboratories, Inc.
American Academy of Pediatrics

© 2021 American Academy of Pediatrics