Transcutaneous bilirubin monitoring predicts unexplained late-onset hemolysis in a very low birthweight infant

• Published in: BMC research notes Vol. 9; no. 153; p. 153
• Main Authors: Nagasaka, Miwako, Kikuma, Tomoe, Iwatani, Sota, Kurokawa, Daisuke, Yamana, Keiji, Maeyama, Kaori, Koda, Tsubasa, Matsumoto, Hisayuki, Taniguchi-Ikeda, Mariko, Iijima, Kazumoto, Nakamura, Hajime, Morioka, Ichiro
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.03.2016; BioMed Central
• Subjects: Age of Onset; Bilirubin - metabolism; Birth weight, Low; Case Report; Erythroblastosis, Fetal - metabolism; Female; Health aspects; Hemolysis and hemolysins; Humans; Infant, Newborn; Infant, Very Low Birth Weight - metabolism; Phototherapy; Skin - metabolism; United States; Hemolysis; Total serum bilirubin; Very low birthweight infant; Transcutaneous bilirubin
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-016-1970-1

In term infants, transcutaneous bilirubin (TcB) monitoring can be used to predict hemolytic hyperbilirubinemia. However, it is not clear whether the technique can also be used to predict unexplained late-onset hemolysis in very low birthweight (VLBW) infants. The case was an infant with a birthweight of 1154 g who developed unexplained late-onset hemolysis at 8 days of age. The hyperbilirubinemia rapidly worsened, and therefore both phototherapy and exchange transfusion were performed. TcB levels were measured using the JM-105 jaundice meter and found to have increased by >3 mg/dL since before the onset, demonstrating for the first time that the device clearly detects changes in hemolytic rate. Although TcB levels did not correspond directly with total serum bilirubin levels in VLBW infants, the two values exhibited parallel changes in this case. Therefore, serial TcB monitoring may be useful in the early prediction of unexplained late-onset hemolysis in VLBW infants.