Indications directory

Incidence 2-5 % of the population. Manifestation usually in adolescence.

Criteria:

Total bilirubin between 1,2 - 3 mg/dl, rarely over 5 mg/dl, increase of unconjugated bilirubin, normal liver enzymes, no evidence of intravascular hemolysis.

Evaluation:       

1. Bilirubin increase during fasting test (in case of 48-hourly calorie reduction to 400 kcal/day, there is a bilirubin increase of 1,5 mg/dl (or 1,8 times the original value) in case of Gilbert’s syndrome, just as in healthy persons, whilst there is no increase in bilirubin in patients with liver parenchymal damage.
2. Bromsulfophthalein test (see Dubin-Johnson-syndrome)
3. Decrease after phenobarbital
4. Molecular-genetic evaluation possible (decreased expression of the UGT1-gene leads to glucoronyl-transferase-insufficiency)