Bronze baby syndrome

Bronze baby syndrome (BBS) is a rare side effect of phototherapy for neonatal jaundice. The exact mechanism of discoloration is not yet known.

In 1972, physicians Arthur E. Kopelman, Ralph S. Brown, and Gerard B. Odell first described the phenomenon in the literature.[1]

BBS occurs when a neonate receiving phototherapy for neonatal jaundice also has a component of direct hyperbilirubinemia. The combination of direct hyperbilirubinemia and phototherapy causes a distinctive bronze/grey discoloration of the skin of the infant. This discoloration of the skin cells is permanent through the life of the cells, so it can take 3-4 weeks to resolve, as the new skin cells made will not have the discoloration. [2]

This discoloration is not overall harmful to the infant, but it is cosmetically concerning to parents and it is hypothesized that it could interfere with transcutaneous monitoring of infants, like pulse oximetry and transcutaneous carbon dioxide monitors used in intensive care, but that effect is not fully studied yet, since the effect is so rare. [3]

Development of BBS is an indication to consider proceeding to exchange transfusion for hyperbilirubinemia in the neonate, though some have reported successful continued treatment despite development of the condition. [4][5][6]

References

  1. ^ The “bronze” baby syndrome: A complication of phototherapy Kopelman, Arthur E. et al. The Journal of Pediatrics, Volume 81, Issue 3, 466 - 472
  2. ^ DOI:10.1007/s13312-013-0161-6
  3. ^ Peinado-Acevedo JS, Chacón-Valenzuela E, Rodríguez-Moncada LL. [Bronze baby syndrome, an unpredictable complication of phototherapy: A case report]. Biomedica. 2018 May 1;38(0):15-18. Spanish. doi: 10.7705/biomedica.v38i0.3593. PMID: 29809326.
  4. ^ Bronze Baby Syndrome Le, Thao-vy Ngoc et al. The Journal of Pediatrics, Volume 188, 301 - 301.e1
  5. ^ DOI: https://doi.org/10.3345/kjp.2019.00528
  6. ^ Peinado-Acevedo JS, Chacón-Valenzuela E, Rodríguez-Moncada LL. [Bronze baby syndrome, an unpredictable complication of phototherapy: A case report]. Biomedica. 2018 May 1;38(0):15-18. Spanish. doi: 10.7705/biomedica.v38i0.3593. PMID: 29809326.


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