Features:
(1) The patient is a neonate with jaundice who is treated with phototherapy.
(2) Almost all infants have significant liver disease, typically with cholestasis.
(3) Following phototherapy the infant develops a dark, grayish-brown skin color.
(4) The plasma and urine show a similar discoloration.
(5) The skin color returns to normal within a few weeks.
Several photoproducts have been implicated in causing the color.
(1) copper porphyrins (coproporphyrins)
(2) biliverdin
(3) photobilirubin
Some of the photoproducts may become polymerized, which may explain the duration of the discoloration.
A bronze baby is at increased risk for kernicterus, and should undergo exchange transfusion at a lower bilirubin level than a normal neonate.
The prognosis for the infant is determined by concurrent diseases, including the underlying liver disease.
