There are certain hallmark diseases and conditions that become ingrained in the mind of the clinician during his or her pediatric residency. Otitis media, nursemaid’s elbow, diabetic ketoacidosis, are examples of the “bread and butter” pediatrics that are the mainstay of most general pediatricians and hospitalists. But probably none more so than hyperbilirubinemia or “jaundice.”
Jaundice affects 60-84% of newborns, is easily detected transcutaneously or via a simple blood test, is easily treated in the majority of cases, and can literally be devastating to the child if missed (Bhutani et al. Pedr Clin North Am.2004; Bhutani et al. J Pediatr. 2013).
It has been more than 10 years since my own pediatric residency, and I still have moments when I need to look up the serum bilirubin nomogram (Fig) to determine what part of the treatment algorithm is necessary for a newborn patient. Some things you just can’t forget.
November’s Pediatrics in Review features an excellent and concise review by Drs. Debra Pan and Yolanda Rivas on the diagnosis and management of jaundice in the newborn to 2-month-old. This article details the causes of both unconjugated and conjugated hyperbilirubinemia, highlighting the common and more rare etiologies and the best diagnostic approaches to these conditions.
Not only was I reminded of the “bread and butter” topic I had learned about during my training, but I learned a few new things as well. I hope that you will too after reading this review.