Gray baby syndrome

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Gray baby syndrome
Classifications and external resources

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 antibiotc chloramphenicol.^[1]

Contents 1 Pathophysiology 2 Clinical features 3 Treatment 4 Prevention 5 Footnotes

[edit] 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]

[edit] 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

[edit] Treatment

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

[edit] Prevention

The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels.^[3][4][5]

[edit] Footnotes

1. ^ McIntyre J, Choonara I (2004). "Drug toxicity in the neonate.". Biol Neonate 86 (4): 218-21. PMID 15249753.
2. ^ Piñeiro-Carrero V, Piñeiro E (2004). "Liver.". Pediatrics 113 (4 Suppl): 1097-106. PMID 15060205.
3. ^ Feder H (1986). "Chloramphenicol: what we have learned in the last decade.". South Med J 79 (9): 1129-34. PMID 3529436.
4. ^ 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.
5. ^ 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.