The “bronze” baby syndrome: A complication of phototherapy

Abstract

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. 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.