KERNICTERUS IN JAPANESE INFANTS. II. PATHOLOGIC DATA IN 25 CASES OF KERNICTERUS AND IN 20 CASES OF SYSTEMIC ICTERUS WITHOUT KERNICTERUS

Clinical and laboratory data are reviewed on 45 infants with systemic icterus born in Hiroshima. An attempt was made to determine why 25 of the infants developed kernicterus while 20 did not. The pattern of involvement and the histologic changes in the central nervous system in the kernicterus group were not essentially different from those in cases with Rh or ABO blood group sensitization regardless of the maturity of the infant. In the nonkernicterus group, no histologic changes were found in the central nervous system. The degree of systemic icterus observed at autopsy was, in the aggregate, greater in the kernicterus than in the nonkernicterus group. There were, however, a few kernicterus cases in which systemic icterus was slight and several nonkernicterus cases in which systemic icterus was moderate or pronounced. It is concluded that some factor other than hyperbilirubinemia is responsible for damage of the central nervous system in kernicterus. There was no evidence to suggest that the development of icterus in the infants was a biological effect of the explosion of an atomic bomb at Hiroshima. (C.H.)