What is the pathophysiology of nonphysiologic jaundice in unconjugated hyperbilirubinemia?

Updated: May 21, 2019
  • Author: Hisham Nazer, MBBCh, FRCP, DTM&H; Chief Editor: BS Anand, MD  more...
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Answer

Breast milk (maternal milk) jaundice results from increased enterohepatic circulation. It is thought to result from an unidentified component of human milk that enhances the intestinal absorption of bilirubin. One possible mechanism for hyperbilirubinemia in breastfed infants is the increased concentration of beta-glucuronidase in breast milk. Beta-glucuronidase deconjugates intestinal bilirubin, increasing its ability to be absorbed (ie, increasing the enterohepatic circulation).

Maternal serum jaundice (Lucey-Driscoll syndrome) may result from the presence of an unidentified inhibitor of UGT, which enters the fetus through maternal serum.


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