ICTERICIA NEONATAL GRAVE SECUNDARIA A ENFERMEDAD HEMOLITICA POR

INCOMPATIBILIDAD ABO, DE PRESENTACION TARDIA.

Introduccin: la ictericia neonatal es la pigmentacin amarillenta de la piel y mucosas
debida a la acumulacin de bilirrubinas derivada del metabolismo de la hemoglobina. El
60% de los casos de ictericia neonatal son de curso benigno, cuando se presenta durante
las primeras 24 horas de vida, los niveles de bilirrubina ascienden rpidamente, superan
los 15 mg/dl o se acompaan de otra sintomatologa hablamos de ictericia patolgica.
Caso clnico: varn de 39 semanas de edad gestacional, que reconsulta a los 5 das de
nacido por ictericia kramer III, hiporexia, hipotona e hipodinamia, hemoclasificacion A+,
madre O+, bilirrubina total de 35 mg/dl y reticulocitos 3,5. Diagnosticado con ictericia
neonatal grave por incompatibilidad de grupo A-O; tratado con fototerapia intensiva y
exanguinotransfusion con recambio total de 480cc, y remisin total del cuadro, sin
evidencia de secuelas neurolgicas.
Discusin: la principal causa de ictericia neonatal patolgica es la enfermedad
hemoltica debida incompatibilidad ABO, esta se manifiesta durante las primeras 24 horas
con un pico mximo al 3 o 4 da de vida, suelen acompaarse de signos neurolgicos lo
que sugieren encefalopata hiperbilirrubinemica, y riesgo para desarrollar kernicterus. Las
manifestaciones clnicas del caso a estudio son compatibles con las de esta patologa a
excepcin de la aparicin del cuadro al 5 da de nacido, con elevacin de bilirrubinas por
encima de los 30 mg/dl en menos de 12 horas y con signos de afectacin neurolgica que
debido al tratamiento oportuno revirtieron sin dejar secuelas.
Palabras clave: ictericia neonatal, hiperbiliIrrubinemia, incompatibilidad ABO, enfermedad
hemoltica.

GRAVE NEONATAL JOUNDICE SECUNDARY TO HEMOLYTIC DESEASE FOR ABO

INCOMPATIBILITY, OF LATE PRESENTATION
Introduction: the jaundice neonatal is the yellowish pigmentation of the skin and mucosa
due to the accumulation de bilirubin derivative from metabolism of the hemoglobin. 60& of
the cases of neonatal jaundice are of course benign, when it present during the first 24
hour of life, the levels of bilirubin ascend quickly, exceed the 15 mg/dl or it accompanied of
other symptomatology saying of pathological jaundice.
Clinical case: male of 39 week of gestational age that re consultation to the 5 of born for
jaundice Kramer III, hyporexia, hypotonia, hypodynamy, hemoclassification A+, mother O+,
total bilirubin of 35 mg/dl and reticulocytes 3,5 %. Diagnosed with grave neonatal jaundice for
incompatibility of group A-O; treated with intensive phototherapy and exananguinotransfusion
with total replacement of 480cc, and total remission of symptoms, without evidence
neurological sequel.
Discussion: the main neonatal pathological jaundice cause is the hemolytic disease due to
ABO incompatibility, it show during the first 24 hour with an peak at 3 or 4th day of life,

usually it accompany of neurological symptoms that suggesting encephalopathy

hyperbilirrubinemica
And risk from develop kernicterus. The evidences clinical from case to study are compatibles
with the this pathology to exception of the appearance of clinical profile at 5 th day of born, with
elevation of bilirubin above the 30 mg/dl in less of 12 hours and with signs of neurological
illness due to opportune treatment revert without leave sequel.

Keywords: neonatal jaundice, hyperbilirrubinemia, ABO incompatibility, hemolytic disease