Gray baby syndrome


Gray baby syndrome

Gray baby syndrome (also termed Gray or Grey syndrome) is a rare but serious side effect that occurs in newborn infants (especially premature babies) following the intravenous administration of the antibiotic chloramphenicol.cite journal | author = McIntyre J, Choonara I | title = Drug toxicity in the neonate. | journal = Biol Neonate | volume = 86 | issue = 4 | pages = 218–21 | year = 2004 | pmid = 15249753 | doi = 10.1159/000079656]

Pathophysiology

Two pathophysiologic mechanisms are thought to play a role in the development of gray baby syndrome after chloramphenicol exposure: [cite book |title= Goodman & Gilman's The Pharmacological Basis of Therapeutics |last= Brunton |first= Laurence L. (Ed.) |authorlink= |coauthors= |year= 2006 |edition = 11th edition |publisher= McGraw-Hill |location= |isbn= 0071422803 |pages= |chapter= Chapter 46. Protein Synthesis Inhibitors and Miscellaneous Antibacterial Agents]
# The UDP-glucuronyl transferase enzyme system of infants, especially premature infants, is immature and incapable of metabolizing the excessive drug load.
# Insufficient renal excretion of the unconjugated drug.

Clinical features

Toxic levels of chloramphenicol after 2–9 days result in:
* Vomiting
* Ashen gray colour of the skin
* Limp body tone
* Hypotension (low blood pressure)
* Cyanosis blue discolouration of lips and skin.
* Hypothermia
* Cardiovascular collapse

Treatment

Chloramphenicol therapy is discontinued immediately; exchange transfusion may be required to remove the drug.

Prevention

The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels, [cite journal | author = Feder H | title = Chloramphenicol: what we have learned in the last decade. | journal = South Med J | volume = 79 | issue = 9 | pages = 1129–34 | year = 1986 | pmid = 3529436] [cite journal | author = Mulhall A, de Louvois J, Hurley R | title = Chloramphenicol toxicity in neonates: its incidence and prevention. | journal = Br Med J (Clin Res Ed) | volume = 287 | issue = 6403 | pages = 1424–7 | year = 1983 | pmid = 6416440 | url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=6416440 | format=Scanned copy & PDF] [cite journal | author = Forster J, Hufschmidt C, Niederhoff H, Künzer W | title = [Need for the determination of chloramphenicol levels in the treatment of bacterial-purulent meningitis with chloramphenicol succinate in infants and small children] | journal = Monatsschr Kinderheilkd | volume = 133 | issue = 4 | pages = 209–13 | year = 1985 | pmid = 4000136] or alternatively, third generation cephalosporins can be effectively substituted for the drug, without the associated toxicity.cite journal
author = Aggarwal, R.
coauthors = Sarkar, N.; Deorari, A.K.; Paul, V.K.
year = 2001
title = Sepsis in the newborn
journal = Indian Journal of Pediatrics
volume = 68
issue = 12
pages = 1143–1147
url = http://www.springerlink.com/index/N7G38R87235Q4246.pdf
accessdate = 2008-05-03
doi = 10.1007/BF02722932
]

References


Wikimedia Foundation. 2010.

Look at other dictionaries:

  • gray syndrome — n a potentially fatal toxic reaction to chloramphenicol esp. in premature infants that is characterized by abdominal distension, cyanosis, vasomotor collapse, and irregular respiration * * * gray baby syndrome a potentially fatal condition seen… …   Medical dictionary

  • syndrome — The aggregate of symptoms and signs associated with any morbid process, and constituting together the picture of the disease. SEE ALSO: disease. [G. s., a running together, tumultuous concourse; (in med.) a concurrence of symptoms, fr. syn,… …   Medical dictionary

  • Meconium aspiration syndrome — Classification and external resources Micrograph of fetal membranes with meconium laden macrophages, a finding that may accompany meconium aspiration. H E stain …   Wikipedia

  • Infant respiratory distress syndrome — Classification and external resources ICD 10 P22 ICD 9 769 …   Wikipedia

  • Amniotic band syndrome — Classification and external resources ICD 10 P02.8 ICD 9 762.8 …   Wikipedia

  • Rumination syndrome — Classification and external resources A …   Wikipedia

  • Congenital rubella syndrome — Classification and external resources Congenital Cataracts (white pupils) due to congenital rubella syndrome ICD …   Wikipedia

  • Liste der Syndrome — Diese Seite listet in alphabetischer Reihenfolge und ohne Anspruch auf Vollständigkeit Syndrome und Komplexe aus unterschiedlichen medizinischen Fachgebieten auf. Bitte nur Verweise auf den tatsächlichen Titel des Beitrags und keine… …   Deutsch Wikipedia

  • List of The Baby-sitters Club novels — This is a list of the novels in The Baby sitters Club, a children s book series created by Ann M. Martin. Titles are followed by either the date of the first printing (month and year) or by the copyright date (just the year). Contents 1 Regular… …   Wikipedia

  • The Baby Maker — Infobox Film name = The Baby Maker image size = caption = director = James Bridges producer = Richard Goldstone Jack Larson writer = James Bridges narrator = starring = Barbara Hershey Scott Glenn Collin Wilcox Paxton Sam Groom music = Fred… …   Wikipedia