Crigler-Najjar vs. physiological jaundice

Discussion in 'Step I' started by kirbymiester, 05.17.14.

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  1. Apoplexy__

    Apoplexy__ Blood-and-thunder appearance Bronze Donor 2+ Year Member

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    What are some ways to tell these two apart?
    -Both present in infancy with an unconjugated bilirubinemia
    -Both can progress to kernicterus
    -Both are treated with phototherapy
    -Both have the same enzyme deficient/insufficient

    Is it just the sort of thing where you assume an infant with unconjugated bilirubinemia has physiological jaundice, then if it persists after a certain point, you re-check UDP-glucuronosyltransferase levels and if they're still low after the certain age then you now have Crigler-Najjar?
     
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  3. Enzymes

    Enzymes 2+ Year Member

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    Yeah, 2 weeks is the magic number. Post 2 weeks, hepatic machinery is mature and the baby should be conjugating bilirubin. Also, I consider CN worse. Usually they are talking about the Type I form that is essentially incompatible with life, so the baby ends up dying in those vignettes. Just my 2 cents.
     
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  4. Apoplexy__

    Apoplexy__ Blood-and-thunder appearance Bronze Donor 2+ Year Member

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    Gotcha. Thanks!
     
  5. bulldogmed

    bulldogmed 2+ Year Member

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    As Dr. Sattar says in Pathoma, Crigler-Najjar sounds like an evil Disney villian, so it's bad = fatal
     

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