gastrins and Jaundice--Neonatal

Gastrin, vasoactive intestinal peptide (VIP) and neurotensin plasma levels were measured in three groups of healthy term newborn infants, on the 3rd, 4th and 5th days of life. Group A consisted of 15 babies without jaundice. Group B comprised of 15 babies with mild jaundice (bilirubin levels < 256 mumol/l) and group C included 15 babies with marked jaundice (bilirubin levels > 256 mumol/l) who received phototherapy for at least 24 h. There was no significant difference in gut hormone levels between groups A and B. Infants in group C had significantly lower gastrin levels compared to infants in groups A and B, on both days 4 and 5. VIP levels on the 4th day of life were significantly higher in group C in comparison to groups A and B. Neurotensin levels in the three groups did not differ significantly. Increased stool number was noted in infants in group C. Increased VIP levels in jaundiced infants under phototherapy may be the cause of increased stool frequency, through stimulation of intestinal water and electrolyte secretion.

Topics: Aging; Feces; Gastrins; Humans; Infant, Newborn; Jaundice, Neonatal; Neurotensin; Phototherapy; Vasoactive Intestinal Peptide

This case describes an extraordinarily elevated total bilirubin level that reverted to normal 9 1/2 wk after Fredet-Ramstedt pyloromyotomy. Although the etiology of jaundice occurring in patients with IHPS remains uncertain, theories implicating inhibition of the glucuronyl transferase system have been proposed. Infants with IHPS have a documented hypergastrinemia. An hypothesis is offered, illustrated by this case, to explain the inhibition of the glucuronyl transferase system with resultant hyperbilirubinemia by the hypergastrinemia of idiopathic hypertrophic pyloric stenosis.

Topics: Exchange Transfusion, Whole Blood; Gastrins; Glucuronosyltransferase; Humans; Hypertrophy; Infant, Newborn; Jaundice, Neonatal; Male; Methods; Pyloric Stenosis