Snapshot A 3-day old newborn girl is evaluated in the hospital for jaundice that was first visible only in her face as seen in the image, but has gradually progressed to the trunk and extremities. She was born at 35 weeks' gestation to a healthy mother with an uncomplicated pregnancy course. On physical examination, her muscle tone is weak in the upper extremities and she has an altered cry. A total serum bilirubin level is measured and is found to be elevated and in the 99th percentile. Introduction Overview login to view 1 more bullet Congenital HyperbilirubinemiaUnconjugated HyperbilirubinemiaSyndromePathophysiologyCharacteristicsGilbert syndromeDefect in glucuronyl transferase5% of populationIncrease in serum unconjugated bilirubinJaundice presents in stressful situationsBenignno treatment necessaryCrigler-Najjar syndromeDeficiency of glucuronyl transferaseMarkedly increased serum unconjugated bilirubinType 1severe jaundice,death from kernicterus is common by 1 year of age; liver transplant is curativeType 2less severe; responds to treatment with phenobarbitalConjugated HyperbilirubinemiaDubin-Johnson syndromeDefective liver excretion of bilirubinIncrease in serum conjugated bilirubinBenignno treatment necessaryLiver turns blackRotor syndromeImpaired hepatic uptake and defective excretion of bilirubinIncrease in serum conjugated bilirubinBenignno treatment necessarymilder than Dubin-Johnson syndromeLiver does not turn black Epidemiology Incidence login to view 6 more bullets ETIOLOGY Pathophysiology login to view 7 more bullets Genetics login to view 4 more bullets Presentation Symptoms login to view 8 more bullets Physical exam login to view 4 more bullets Studies Serum bilirubin level login to view 4 more bullets Complete blood cell count login to view 1 more bullet Differential Physiologic neonatal jaundice (benign congenital hyperbilirubinemia) login to view 3 more bullets Treatment Medical login to view 3 more bullets Surgical login to view 2 more bullets Complications Kernicterus login to view 6 more bullets Prognosis Gilbert syndrome login to view 2 more bullets Crigler-Najjar syndrome login to view 1 more bullet Dubin-Johnson syndrome login to view 2 more bullets Rotor syndrome login to view 2 more bullets