Abstract
In Reply.— Ours was a retrospective, controlled study of the clinical-pathologic correlates of kernicterus. Cases with kernicterus at autopsy were matched by gestational age, weight, and length of survival with paired control infants. The same neuropathologist was responsible for the initial processing and diagnosis of all the cases. On review, we found the expected histologic features of toxic bilirubin encephalopathy in only two of 32 cases with characteristic gross bilirubin staining at autopsy. Spongy change was found in no predictable anatomic location in the remaining cases.
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