If bilirubin levels exceed 20 mg/dL in a neonate, what condition might develop?

When bilirubin levels exceed 20 mg/dL in a neonate, kernicterus is a serious condition that may develop due to bilirubin toxicity. Kernicterus refers to a type of brain damage that occurs when there is a high level of unconjugated (indirect) bilirubin in the bloodstream, which can cross the blood-brain barrier. This can lead to neurological damage and long-term complications if not addressed promptly.

The risk of kernicterus increases significantly when bilirubin levels are above critical thresholds, usually around 20 mg/dL in neonates. Symptoms of kernicterus may include lethargy, poor feeding, a high-pitched cry, and abnormal muscle tone. Immediate medical attention is necessary to prevent permanent damage.

Other conditions listed, such as sepsis, jaundice, and dehydration, do not directly result from bilirubin levels that are excessively high, though jaundice is a common symptom associated with elevated bilirubin. However, jaundice itself is a less severe condition than kernicterus. Understanding the progression from elevated bilirubin to kernicterus highlights the importance of monitoring and managing bilirubin levels in newborns to prevent irreversible damage.