Gray baby syndrome
| Gray baby syndrome | |
| ICD-10 | P93 |
|---|---|
| ICD-9 | 779.4 |
| MedlinePlus | 007049 |
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.[1]
Pathophysiology
Newborn infants are predisposed to this condition because they do not yet have fully functional liver enzymes, nor do they have enough enzymes to handle the drug.[2]
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.[3][4][5]
Footnotes
- ↑ McIntyre J, Choonara I (2004). "Drug toxicity in the neonate". Biol Neonate. 86 (4): 218–21. PMID 15249753.
- ↑ Piñeiro-Carrero V, Piñeiro E (2004). "Liver". Pediatrics. 113 (4 Suppl): 1097–106. PMID 15060205.
- ↑ Feder H (1986). "Chloramphenicol: what we have learned in the last decade". South Med J. 79 (9): 1129–34. PMID 3529436.
- ↑ Mulhall A, de Louvois J, Hurley R (1983). "Chloramphenicol toxicity in neonates: its incidence and prevention" (Scanned copy & PDF). Br Med J (Clin Res Ed). 287 (6403): 1424–7. PMID 6416440.
- ↑ Forster J, Hufschmidt C, Niederhoff H, Künzer W (1985). "[Need for the determination of chloramphenicol levels in the treatment of bacterial-purulent meningitis with chloramphenicol succinate in infants and small children]". Monatsschr Kinderheilkd. 133 (4): 209–13. PMID 4000136.