Possible Delayed Activation of Uridine Diphosphate Glucuronosyl Transferase (UGT) Enzyme causing Severe Unconjugated Hyperbilirubinemia in a Newborn

Bhabesh Kant Chowdhry; Royal Singh; Arun Prasad; Chandra Mohan  Kumar; Shweta Singh

Bhabesh Kant Chowdhry Department of Neonatology, All India Institute of Medical Sciences, Patna, Bihar, India.
Royal Singh Department of Paediatrics, All India Institute of Medical Sciences, Patna, Bihar, India.
Arun Prasad Department of Paediatrics, All India Institute of Medical Sciences, Patna, Bihar, India.
Chandra Mohan Kumar Department of Paediatrics, All India Institute of Medical Sciences, Patna, Bihar, India.
Shweta Singh Department of Biochemistry, MDBAS Medical College, Deoria, Uttar Pradesh, India.

Keywords: Neonatal Jaundice, Encephalopathy, Phototherapy, Conjugation

Abstract

Neonatal jaundice is a common medical condition in newborns. Some babies require phototherapy but very few babies develop bilirubin encephalopathy or require exchange transfusion. Most of them are due to haemolytic conditions and UGT enzyme deficiency syndromes. We present a case with serum bilirubin > 50 mg/dl at presentation who required four times exchange transfusions and then recovered completely without residual damage, whose investigations revealed no plausible explanation for such high unconjugated bilirubinemia and the clinical course underlining the transient nature of the disease thus suspected of delayed maturation of UGT enzyme activity in a term neonate. UGT enzyme activity may remain absent in the early few days leading to severe unconjugated bilirubinemia requiring multiple exchange transfusions, however, complete enzymatic activation may happen by day 10 and the baby may recover without any residual damage.

How to cite this article:
Chowdhry BK, Singh R, Prasad A, Kumar CM, Singh S. Possible Delayed Activation of Uridine Diphosphate Glucuronosyl Transferase (UGT) Enzyme causing Severe Unconjugated Hyperbilirubinemia in a Newborn. Postgrad J Pediatr Adol Med. 2022;1(1):52-58.

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