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Related Experiment Videos

Kernicterus in an adult.

M Waser, P Kleihues, P Frick

    Annals of Neurology
    |June 1, 1986
    PubMed
    Summary

    Adult kernicterus is rare, but occurred in a patient with severe liver damage. Treatment complications led to high bilirubin levels, causing brain damage and hepatic coma.

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    Area of Science:

    • Hepatology
    • Neurology
    • Toxicology

    Background:

    • Severe hepatic damage, likely from non-A, non-B hepatitis, presented in a 43-year-old woman with jaundice.
    • The patient underwent extracorporeal charcoal-column perfusion for treatment.

    Observation:

    • The patient developed a hepatic coma and died two weeks after treatment initiation.
    • Autopsy revealed kernicterus, characterized by bilirubin staining in the brain's hippocampus, subthalamic nuclei, and cerebellar dentate nuclei.

    Findings:

    • Extracorporeal charcoal-column perfusion caused significant fibrinogen depletion, leading to extensive hemorrhages.
    • The treatment overloaded the compromised hepatic glucuronyl-transferase, resulting in elevated unconjugated bilirubin levels.

    Implications:

    • This case highlights the rare occurrence of adult kernicterus.
    • Therapeutic interventions can precipitate bilirubin encephalopathy in patients with severe liver dysfunction.
    • Careful monitoring of coagulation and bilirubin levels is crucial during such treatments.

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