A Case of Gilberts Syndrome Combined with Hemolysis

Gilbert's Syndrome is the name most frequently used to describe a condition which has been called constitutional heptic dysfunction, familial nonhemolytic jaundice of icterus intermittens juvenilis. It is characterized by a benign, persistent, but variable elevation of the plasma unconjugated bilirubin. A 27-year-old man was admitted because of general malaise, anorexia, sore throat and slight icteric sclera. On physical examination, there were mild icteric sclera and slightly injected pharynx. The liver was palpable 1 finger breath BRCM and the spleen was also palpable I finger breadth BLCM. Hematologic studies revealed slight anemia with slightly elevated corrected reticulocyte count. Liver function tests were normal except for slightly elevated serum total bilirbin. Histolog-ic findings of the liver showed nonspecific findings of mild cholestasis. Reduction in caloric intake to 300 calrory a day for 72 hours resulted in a significant increase in the plasma bilirubin concentration(especially unconjugated form) in this patient. Now he has no subjective symptoms and leads a normal activity without specific treatment.