Gray-brown skin discoloration following phototherapy for hyperbilirubinemia due to anti-E alloimmunization

A female infant was born by spontaneous vaginal delivery at 40 weeks and 3 days of gestation with a birth weight of 3,500 g from the third pregnancy of a 38-year-old woman. The laboratory values observed at that point are presented in Table 1. * Based on the clinical findings, what is the expected diagnosis? * ① Gray baby syndrome * ② Bronze baby syndrome * ③ Dusky-hued neonate * ④ Photosensitivity What is the bronze baby syndrome and which diseases should be differentiated from it? BBS, an unusual neonatal dyschromia, develops in jaundiced neonates following phototherapy and is characterized by a diffuse gray-brown pigmentation of the skin [1-3]. [10] stated that the continuation of phototherapy presented a risk of cholestasis to newborns with BBS and recommended that it be suspended; however, phototherapy can be reinitiated when the direct bilirubin level decreases and cholestasis has resolved. [...]an appropriate choice must be made based on the patient’s condition.