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Bilirubin and Phototherapy

Bilirubin (formerly referred to as hematoidin) is the yellow breakdown product of normal heme catabolism. Heme is found in hemoglobin, a principal component of red blood cells. Bilirubin is excreted in bile, and its levels are elevated in certain diseases. It is responsible for the yellow color of bruises and the yellow discoloration in jaundice. Bilirubin is the waste product that results from the breakdown of hemoglobin molecules from worn out red blood cells. Ordinarily, it is excreted from the body as the chief component of bile. Excessive levels of bilirubin stain the fatty tissues in the skin yellow; this condition is called jaundice. Very high levels of bilirubin in the bloodstream can cause permanent damage to certain areas of the brain of newborn infants - kernicterus. This can cause a characteristic form of crippling known as athetoid cerebral palsy. To prevent this from happening, bilirubin levels are monitored in newborns, and excessive levels of bilirubin are treated by either phototherapy ("bilirubin lights") or exchange transfusion.

Phototherapy. Newborns with moderately severe jaundice are placed under powerful florescent lights which are designed to emit light at a specific wavelength which is known to break down the bilirubin molecule. This molecule is converted from the toxic, fat soluble form which can enter and damage the baby's brain tissues to a harmless, water soluble form which is excreted in the urine and stool more readily.
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