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Das Verhalten der Bilirubinfraktionen bei verschiedenen Ikterusformen im Säuglingsalter

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Zusammenfassung

In 120 Seren von Neugeborenen und Säuglingen wurden die Fraktionen des Serumbilirubins nach der Lösungsmittelverteilungsmethode (Eberlein) bestimmt. Die Übereinstimmung mit der Diazomethode (Jendrassik undGrof) war für das Gesamtbilirubin befriedigend.

Frühgeborene und Neugeborene mit Morbus haemolyticus neonatorum hatten hohe Konzentrationen von freiem Bilirubin bei relativ starker Vermehrung der Monoglucuronidfraktion. Säuglinge mit Obstruktionsikterus verschiedener Genese zeigten die erwartete Vermehrung des Diglucuronids und wechselnd hohe Konzentration von Monoglucuronid.

Ob eien Differentialdiagnose zwischen Gallengangsatresie und Säuglingshepatitis mit komplettem Verschluß mit Hilfe der Fraktionierung des Bilirubins möglich ist, scheint fraglich. Möglicherweise läßt das Verhalten des Quotienten, der aus der Summe von freiem Bilirubin und Monoglucuronid zu Diglucuronid errechnet wird, eine Unterscheidung zu.

Summary

Fractions of serum bilirubin were determined in 120 sera of infants usingEberlein's solvent partition method. Total serum bilirubin values estimated byEberlein's method and by the diazo method (Jendrassik andGrof) showed a satisfactory correlation.

Prematures and newborns with morbus haemolyticus neonatorum showed high concentrations of free (unconjugated) bilirubin and a relatively high monoglucuronide fraction. Infants with obstructive icterus of various aetiology showed the expected increase of diglucuronide and varying concentrations of monoglucuronide.

It remains questionable wether the differential diagnosis between medical and surgical jaundice is possible by use of the fractionation method. The data presented suggest that a differentiation may be possible by determining the ratio of the sum of monoglucuronide and unconjugated bilirubin and diglucuronide.

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Authors and Affiliations

  1. Aus der Universitäts-Kinderklinik Bonn, Germany

    Sabina Kowalewski, G. Flatz & H. W. Rotthauwe

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  1. Sabina Kowalewski
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  2. G. Flatz
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  3. H. W. Rotthauwe
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Technische Assistenz:Heidi Hammann.

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Kowalewski, S., Flatz, G. & Rotthauwe, H.W. Das Verhalten der Bilirubinfraktionen bei verschiedenen Ikterusformen im Säuglingsalter. Klin Wochenschr 42, 527–533 (1964). https://doi.org/10.1007/BF01486681

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