Conjunctival Icterus – An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates

Title:Conjunctival Icterus – An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates

Volume: 13 Issue: 3

Author(s): Abeer Azzuqa and Jon F. Watchko*

Affiliation:

• Division of Newborn Medicine, Department of Pediatrics, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, Pennsylvania 15213,United States

Keywords: Scleral icterus, conjunctiva, Bhutani nomogram, bilirubin screening, neonatal jaundice, dermal icterus, cutaneous jaundice.

Abstract: Background: Conjunctival icterus is a largely neglected physical sign that may be helpful in identifying neonates with clinically relevant hyperbilirubinemia by practitioners in the hospital and outpatient clinic or parents at home.

Objective: A recent NICU based study reported that conjunctival icterus is often a sign of significant (TSB ≥ 17 mg/dl) hyperbilirubinemia and TSB levels ≥ 76^th-95^th percentile on the Bhutani nomogram. In contrast, others report that conjunctival icterus, although frequently present at high TSB levels, may also be detected at lower TSB concentrations; suggesting instead that its absence may help to rule out significant hyperbilirubinemia.

Result and Conclusion: The current review details the nature of conjunctival icterus and presents new data on its clinical occurrence in relation to TSB levels that re-affirm its correlation with elevated TSB concentrations and use to trigger TSB measurement in the jaundiced neonate.

Cite this article as:

Azzuqa Abeer and Watchko F. Jon *, Conjunctival Icterus – An Important but Neglected Sign of Clinically Relevant Hyperbilirubinemia in Jaundiced Neonates, Current Pediatric Reviews 2017; 13 (3) . https://dx.doi.org/10.2174/1573396313666170718145535