Gilbert Syndrome with Case

by Kelley Chuang, MD

My Notes
  • Required.
Save Cancel
    Learning Material 2
    • PDF
      Slides Gastroenterology 16 Approach to Jaundice.pdf
    • PDF
      Download Lecture Overview
    Report mistake

    00:00 Let's move on to a next case, A 30-year-old man with no past medical history is seen in clinic for intermittent yellowing of his eyes.

    00:09 He currently feels well with no complaints.

    00:12 Two weeks ago, he noticed his eyes turn yellow for a few days.

    00:16 He had a seasonal cold virus at that time.

    00:19 It resolved without any intervention.

    00:22 Vitals are normal, physical exam is unremarkable and there is no hepatosplenomegaly.

    00:27 His labs show a total bilirubin of 2.5 (mg/dL) with direct bilirubin 0.4 (mg/dL).

    00:34 His CBC, AST, ALT, alkaline phosphatase, and GGT and Albumin are all normal, and the peripheral smear is also normal.

    00:43 So what is the most likely diagnosis? So, let's review.

    00:49 He is a young, healthy male, with intermittent jaundice that occurs during periods of stress as noted when he had this occurred during a cold virus.

    00:59 He has a mild isolated, unconjugated hyperbilirubinemia.

    01:05 But the rest of his lab studies are fairly normal.

    01:08 So, that brings us back to our diagnostic algorithm for hyperbilirubinemia.

    01:13 We can hone in on the fact as mostly unconjugated or indirect hyperbilirubinemia and it's an isolated bilirubin elevation.

    01:23 So that brings to either hemolysis, Gilbert Syndrome or Crigler-Najjar Syndrome.

    01:28 We return to our case at this point.

    01:31 We also noticed here that he has a normal peripheral smear.

    01:36 This indicates that he has no ongoing hemolysis.

    01:39 So now, we know our most likely diagnosis is Gilbert Syndrome.

    01:44 You might have noticed that Crigler-Najjar is also on the differential here but it is a congenital condition, so usually it would present earlier in life and would not present at the age of 30.

    01:57 Thank you very much for your attention.

    About the Lecture

    The lecture Gilbert Syndrome with Case by Kelley Chuang, MD is from the course Disorders of the Hepatobiliary Tract.

    Included Quiz Questions

    1. Gilbert syndrome
    2. Viral hepatitis
    3. Autoimmune hepatitis
    4. Wilson disease
    5. Rotor syndrome

    Author of lecture Gilbert Syndrome with Case

     Kelley Chuang, MD

    Kelley Chuang, MD

    Customer reviews

    5,0 of 5 stars
    5 Stars
    4 Stars
    3 Stars
    2 Stars
    1  Star