Anemia and Jaundice in a Newborn
Charles T. Quinn, MD, MS
Cincinnati Children's Hospital Medical Center
Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.
This case was reviewed and updated in June 2011 by The Teaching Cases Subcommittee.
A 7-day-old Caucasian girl is referred to you to determine whether her jaundice is caused by a blood disorder. She was the 3.5 kg product of a term gestation born to a 28 year-old gravida 2 para 2 mother. Prenatal care was appropriate, and the baby was delivered at a local hospital. Mild jaundice limited to the face was seen in the first 12 hours of life. At 48 hours of life both the face and upper chest were jaundiced. Routine serologic tests for congenital infections (e.g., toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex virus) were negative.
The baby was thought to have physiologic jaundice, which is transient jaundice caused by the physiologically normal unconjugated hyperbilirubinemia of newborns. Physiologic jaundice typically appears in the second to fifth days of life, but not in the first 24 hours. The baby was discharged from the nursery at 48 hours of age. She is now feeding avidly and beginning to gain weight.
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