Gilbert's syndrome, also known as constitutional hepatic dysfunction or hereditary nonhemolytic hyperbilirubinemia.

bubble_chart Diagnosis

1. Medical History and Symptoms

This disease is more common in males and can occur at any age, but is most frequently seen between 15 and 20 years old. Patients typically have no obvious symptoms and are in good general health. Clinically, it is characterized by chronic or recurrent jaundice, which may remain stable or fluctuate significantly. Emotional stress, fatigue, cold exposure, alcohol consumption, or concurrent infections can exacerbate jaundice. When jaundice worsens, symptoms such as lack of strength, indigestion, or grade I liver pain may occur. Differentiation from hemolytic jaundice is necessary.

2. Physical Examination

Yellow staining of the sclera membrane is observed, and the liver may occasionally be palpable.

3. Auxiliary Examinations

Liver function tests show normal ALT or grade I elevation, with increased total serum bilirubin, predominantly unconjugated bilirubin. The low-calorie (400 kcal/day) test reveals a more than twofold increase in unconjugated bilirubin after 24 hours. The phenobarbital test is positive, meaning that after oral administration of 180 mg/day of phenobarbital for three days, unconjugated bilirubin decreases by more than 50% or even returns to normal. Red blood cell fragility tests are normal, and reticulocyte counts are not elevated.

Imaging Studies: The gallbladder appears normal on imaging.

bubble_chart Treatment Measures

The prognosis of this disease is good, and generally no special treatment is required. Phenobarbital at a dose of 40–18 μg/d can rapidly reduce the elevated blood bilirubin to normal levels.