Uzamış sarılıklı bebeklerde etyolojik dağılım
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Date
2008
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Uludağ Üniversitesi
Abstract
Amaç: Bu çalışmanın amacı, uzamış sarılık ile başvuran bebeklerdeki etyolojinin belirlenmesidir. Gereç ve Yöntem: Prospektif olarak düzenlenen bu çalışmaya Ocak 2007-Aralık 2007 tarihleri arasında uzamış sarılık şikayeti ile başvuran yenidoğan bebekler alındı. On dört gününü doldurmuş bebeklerde total bilurbin düzeyinin >5mg/dl olması uzamış sarılık olarak kabul edildi. Ayrıntılı öykü ve fizik muayenenin ardından tüm hastalardan hemogram, anne ve bebek kan grubu, retikülosit, direkt coombs testi, total, direkt ve indiret bilirubin (TB, DB, ‹B), periferik yayma, serum alanin transferaz (ALT), serum aspartat transferaz (AST), tiroid fonksiyon testleri, viral belirteçler, enzim kanları, glikoz-6 fosfat dehidrogenazı içeren kan testleri ile birlikte tam idrar tetkiki ve idrar kültürü gönderildi. Bulgular: Çalışmaya toplam 154 vaka alındı. Etyolojide ilk sırada anne sütü sarı- lığı (%53) saptandı. Bunu idrar yolu enfeksiyonu ve klinik sepsis (%29), kan grubu uygunsuzluğuna bağlı hemolitik nedenler (%10) ve konjenital hipotiroidi (%8) takip etmekte idi. Etyoloji ile ortalama bilirubin düzeyleri arasında anlamlı bir ilişki olmadığı saptanmıştır. Sonuç: Uzamış sarılıklı hastalarda etyolojinin belirlenmesi ve buna yönelik tedavinin planlanması önemlidir. Uzamış sarılık ile başvuran bebeklerde ilk planda anne sütü sarılığı, idrar yolu enfeksiyonu ve sepsis, hipotiroidi ve hemolitik nedenler düşünülmelidir.
Aim: The aim of this study is to determine the etiology in neonates admitted with prolonged jaundice. Materials and Method: Neonates with prolonged jaundice were included to this prospective study designed between January 2007 and December 2007. Prolonged jaundice was defined as total bilirubin level >5 mg/dL in newborns older than 14 days of age. After detailed history and physical examination, blood tests including blood groups of baby and mother, total, direct and indirect bilirubin, complete blood count (CBC), blood smear, reticulocyte count, Coombs test, serum aspartat transaminase (AST) level, serum alanin transaminase (ALT) level, viral markers, thyroid function tests, and glucose-6 phosphate dehydrogenase (G-6 PD) level and routine urine analysis with urine culture were performed in all newborns. Results: A total of 154 neonates were enrolled to the study. The most frequent cause of prolonged jaundice was breast milk jaundice (53%). It was followed by urinary tract infections and clinical sepsis (29%), hemolytic causes due to blood group incompetency (10%) and congenital hypothyroidism (8%). However, there were no significant differences between etiology and mean bilirubin levels. Conclusion: It is important to determine the etiology and to plan therapy according to etiology is important in newborns with prolonged jaundice. Breast milk jaundice, urinary tract infection and sepsis, hypothyroidism and hemolytic causes must be considered as the main etiology in newborns with prolonged jaundice.
Aim: The aim of this study is to determine the etiology in neonates admitted with prolonged jaundice. Materials and Method: Neonates with prolonged jaundice were included to this prospective study designed between January 2007 and December 2007. Prolonged jaundice was defined as total bilirubin level >5 mg/dL in newborns older than 14 days of age. After detailed history and physical examination, blood tests including blood groups of baby and mother, total, direct and indirect bilirubin, complete blood count (CBC), blood smear, reticulocyte count, Coombs test, serum aspartat transaminase (AST) level, serum alanin transaminase (ALT) level, viral markers, thyroid function tests, and glucose-6 phosphate dehydrogenase (G-6 PD) level and routine urine analysis with urine culture were performed in all newborns. Results: A total of 154 neonates were enrolled to the study. The most frequent cause of prolonged jaundice was breast milk jaundice (53%). It was followed by urinary tract infections and clinical sepsis (29%), hemolytic causes due to blood group incompetency (10%) and congenital hypothyroidism (8%). However, there were no significant differences between etiology and mean bilirubin levels. Conclusion: It is important to determine the etiology and to plan therapy according to etiology is important in newborns with prolonged jaundice. Breast milk jaundice, urinary tract infection and sepsis, hypothyroidism and hemolytic causes must be considered as the main etiology in newborns with prolonged jaundice.
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Keywords
Uzamış sarılık, Yenidoğan, Etyoloji, Prolonged jaundice, Newborn, Etiology
Citation
Çetinkaya, M. vd. (2008). "Uzamış sarılıklı bebeklerde etyolojik dağılım". Güncel Pediatri, 6(3), 99-103.