Pathologic - Production
Pathologic jaundice
Production
The pathologic counterpart of the normally increased hemoglobin of the newborn is neonatal polycythemia, with hemoglobins exceeding 22 gm/dL. The pathologic correlate of the normally shortened neonatal RBC life span is hemolytic disease of the newborn. This can be congenital or acquired. Another clinical condition associated with increased RBC destruction is enclosed hemorrhages (e.g., cephalhematomas). Giant hemangiomas can trap RBCs leading to hemolysis. A very rare cause of pathologic jaundice in the newborn due to hemolysis is congenital erythropoeitic porphyria. Pink urine, cutaneous bullae and severe photosensitivity suggest the diagnosis. It is important to identify this disease before phototherapy is begun, because the intense light induces severe skin inflammation, worsening the bullae, and may be fatal.Return to top of page