Hiperbilirrubinemia neonatal, encefalopatía bilirrubínica aguda y Kernicterus: La secuencia sigue vigente en el siglo XXI

  • Mirta Mesquita
  • Marco Casartelli
Palabras clave: Hiperbilirrubinemia neonatal; encefalopatía bilirrubínica; Kernicterus; ictericia.

Resumen

Aunque la ictericia afecta a más de la mitad de los neonatos en la primera semana de vida, sólo un grupo de ellos pueden desarrollar hiperbilirrubinemia severa y estar en riesgo de desarrollar encefalopatía bilirrubínica. La afectación neurológica puede presentarse con un cuadro agudo (la encefalopatía bilirrubínica aguda), la cual puede o no progresar a una forma crónica (Kernicterus), o con una constelación de síntomas sensoriales, motores y cognitivos, subagudos o crónicos, dependiendo de la presencia de factores de riesgo que aumentan la susceptibilidad al daño neurológico. La bilirrubina libre interactúa con citoquinas inflamatorias y es la responsable del daño neuronal y de las células de la glía en el sistema nervioso central. A pesar de las diferentes medidas de prevención de hiperbilirrubinemia severa, se siguen reportando casos de Kernicterus sobre todo en países en vías de desarrollo, en algunos de los cuales constituyen un problema de salud pública.

Citas

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Publicado
2017-11-09
Sección
Artículos de Revisión