Conjunctival Icterus – An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates

Author(s): Abeer Azzuqa, Jon F. Watchko*.

Journal Name: Current Pediatric Reviews

Volume 13 , Issue 3 , 2017

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Abstract:

Background: Conjunctival icterus is a largely neglected physical sign that may be helpful in identifying neonates with clinically relevant hyperbilirubinemia by practitioners in the hospital and outpatient clinic or parents at home.

Objective: A recent NICU based study reported that conjunctival icterus is often a sign of significant (TSB ≥ 17 mg/dl) hyperbilirubinemia and TSB levels ≥ 76th-95th percentile on the Bhutani nomogram. In contrast, others report that conjunctival icterus, although frequently present at high TSB levels, may also be detected at lower TSB concentrations; suggesting instead that its absence may help to rule out significant hyperbilirubinemia.

Result and Conclusion: The current review details the nature of conjunctival icterus and presents new data on its clinical occurrence in relation to TSB levels that re-affirm its correlation with elevated TSB concentrations and use to trigger TSB measurement in the jaundiced neonate.

Keywords: Scleral icterus, conjunctiva, Bhutani nomogram, bilirubin screening, neonatal jaundice, dermal icterus, cutaneous jaundice.

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Article Details

VOLUME: 13
ISSUE: 3
Year: 2017
Page: [169 - 175]
Pages: 7
DOI: 10.2174/1573396313666170718145535

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