Gilbert’s syndrome

Clinic A/P, adults, Clinic A/P, Peds, Hospital A/P, Adults, Hospital A/P, Peds

Also called constitutional hepatic dysfunction and familial nonhemolytic jaundice

Hereditary asymptomatic unconjugated hyperbilirubinemia

“Gilbert syndrome is a hereditary condition characterized by a 70% reduction in the ability to conjugate bilirubin, resulting in asymptomatic intermittent unconjugated hyperbilirubinemia. Gilbert syndrome is present in 5% to 10% of Western European populations.”

unconjugated hyperbilirubinemia is usually with a bilirubin level <5.0 mg/dL). The bilirubin level increases with infection, exertion, and fasting.

Order: a peripheral blood smear, lactate dehydrogenase, and haptoglobin to evaluate for hemolysis.

Repeat bilirubin measured 6 and 12 months later. The diagnosis of Gilbert syndrome can be made in patients who continue to have normal laboratory results (other than the elevation in serum bilirubin) during the next 12 months.

DDx includes:

  • Hemolysis. Hemolytic anemias, which cause a decrease in serum haptoglobin, an increase in LDH, and/or CBC abnormalities, particularly on the peripheral smear.
  • Drug-induced hyperbilirubinemia.

Read this article.

References

VanWagner LB, Green RM. Evaluating Elevated Bilirubin Levels in Asymptomatic Adults. JAMA. 2015;313(5):516-517. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424929/

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