Grey baby syndrome is a rare but serious condition occurring in infants and young children due to accumulation of Chloramphenicol(an antibiotic).
Pathophysiology:
Toxic levels of Chloramphenicol in body occurs due to following reasons;
- Decreased metabolism of drug:Normally, the drug is metabolised by the enzyme UDP-glucuoryl transferase.In infants,the enzyme system is immature and incapable of metabolising high dose of drug.
- Decrease renal excretion of unconjugated drug.
Symptoms:
Toxic levels of chloramphenicol after 2–9 days result in:
- Loss of appetite
- Vomiting
- Gray color of the skin
- Hypotension (low blood pressure)
- Cyanosis (blue discolouration of lips and skin)
- Hypothermia
- Cardiovascular collapse
- Flaccidity
- Abdominal distension
- Irregular respiration
Treatment and prevention:
To avoid Chloramphenicol toxicity, the dose of drug should be minimum and within safe range.
If the toxicity occurs,the drug should be immediately stopped.Exchange transfusion may be required to remove the drug. Sometimes, phenobarbital (UGT induction) is used.
