Hyperbilirubinemia | How to Reduce Bilirubin Level in Your Body?

Management of unconjugated hyperbilirubinemia

The treatment of this condition depends on the diagnosis and the type of patient. For example, in the case of mild neonatal jaundice, it does not require treatment and usually solves on its own after a few weeks. But when it is moderate or severe, newborns receive phototherapy as one of the first options. This is exposure to blue-green light that helps transform bilirubin and eliminate the waste substance through the urine and the stools. Infants born from parents with differences in blood type may have antibodies that break down red blood cells and require intravenous immunoglobulins or a blood transfusion.

Management of genetic problems such as Gilbert syndrome and Crigler-Najjar Type II syndrome depends on each case. There is currently no way to replace the impaired enzyme. Instead, phototherapy, oral calcium phosphate, exchange transfusions, plasmapheresis, and phenobarbital can be used to normalize bilirubin levels.

The prognosis of these diseases is favorable when the source is detected and the condition is treated. Still, patients with Crigler Najjar syndrome are at a higher risk and require constant monitoring. Most of these patients can live a normal life, but they need follow-up from an early age to ensure that bilirubin does not reach a threshold level.

The main complication of hyperbilirubinemia is bilirubin encephalopathy and kernicterus, which happens when unconjugated bilirubin is deposited in brain cells, causing necrosis and neural damage in different parts of the brain. These patients develop seizures, cerebral palsy, deafness, and other manifestations. Thus, medical monitoring is fundamental to maintaining a good quality of life and intact cognitive and neurologic functioning.

References

Singh, A., & Jialal, I. (2019). Unconjugated hyperbilirubinemia.

Tripathi, N., & Jialal, I. (2020). Conjugated Hyperbilirubinemia. StatPearls [Internet].

Reddy, D. K., & Pandey, S. (2020). Kernicterus. StatPearls [Internet].

Bhandari, J., Thada, P. K., & Yadav, D. (2020). Crigler Najjar Syndrome. StatPearls [Internet].

Joseph, A., & Samant, H. (2020). Jaundice. StatPearls [Internet].

Hall, V., & Avulakunta, I. D. (2021). Hemolytic Diseases Of The Newborn. StatPearls [Internet].