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Conjunctival Icterus - An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates.
Curr Pediatr Rev. 2017; 13(3):169-175.CP

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.

Authors+Show Affiliations

Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, 15213, Pennsylvania. United States.Division of Newborn Medicine, Department of Pediatrics, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, Pennsylvania 15213. United States.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28721815

Citation

Azzuqa, Abeer, and Jon F. Watchko. "Conjunctival Icterus - an Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates." Current Pediatric Reviews, vol. 13, no. 3, 2017, pp. 169-175.
Azzuqa A, Watchko JF. Conjunctival Icterus - An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates. Curr Pediatr Rev. 2017;13(3):169-175.
Azzuqa, A., & Watchko, J. F. (2017). Conjunctival Icterus - An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates. Current Pediatric Reviews, 13(3), 169-175. https://doi.org/10.2174/1573396313666170718145535
Azzuqa A, Watchko JF. Conjunctival Icterus - an Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates. Curr Pediatr Rev. 2017;13(3):169-175. PubMed PMID: 28721815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conjunctival Icterus - An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates. AU - Azzuqa,Abeer, AU - Watchko,Jon F, PY - 2017/02/23/received PY - 2017/07/06/revised PY - 2017/07/12/accepted PY - 2017/7/20/pubmed PY - 2018/2/22/medline PY - 2017/7/20/entrez KW - Bhutani nomogram KW - Scleral icterus KW - bilirubin screening KW - conjunctiva KW - cutaneous jaundice KW - dermal icterus KW - neonatal jaundice SP - 169 EP - 175 JF - Current pediatric reviews JO - Curr Pediatr Rev VL - 13 IS - 3 N2 - 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. SN - 1875-6336 UR - https://www.unboundmedicine.com/medline/citation/28721815/Conjunctival_Icterus___An_Important_but_Neglected_Sign_of_Clinically_Relevant_Hyperbilirubinemia_in_Jaundiced_Neonates_ L2 - http://www.eurekaselect.com/154284/article DB - PRIME DP - Unbound Medicine ER -