Elsevier

The Journal of Pediatrics

Volume 81, Issue 3, September 1972, Pages 466-472
The Journal of Pediatrics

Original article
The “bronze” baby syndrome: A complication of phototherapy*

https://doi.org/10.1016/S0022-3476(72)80172-0Get rights and content

An intense grey-brown discoloration of the skin, serum, and urine, and anemia occurred in a premature infant when phototherapy was used to reduce hyperbilirubinemia. Pre-existing hepatic disease was suspected as a cause of the joundice and may have prevented the biliary excretion of the photooxidation products of bilirubin; their retention resulted in the bronze discoloration. A disproportionately high saturation of the serum albumin with bilirubin was observed, suggesting that the retained pigments may compete with bilirubin for protein binding or that the phototherapy altered the capacity of albumin to bind bilirubin.

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      Phototherapy is the most common intervention for the treatment and prevention of severe hyperbilirubinemia. It is considered a safe intervention because it has been widely used in millions of infants although there are concerns about the increased mortality rate of extremely low-birth weight infants due to aggressive phototherapy6 and bronze baby syndrome.7 The mechanism of phototherapy involves photochemically altered excretion of (ZE)-bilirubin and (EZ)-/(EE)-cyclobilirubin.8

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    *

    Supported by United States Public Health Service Grants HD-00091 and HD-02268.

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