title: Unconjugated hyperbilirubinemia in nonalcoholic steatohepatitis--is it Gilbert's syndrome?
abstract: BACKGROUND
  Patients with nonalcoholic steatohepatitis (NASH) have normal liver function tests except for raised transaminases until they have progressed to cirrhosis of liver. The objective of this study was to evaluate patients of NASH for the presence of hyperbilirubinemia at presentation.
  
  
  METHODS
  Sixty-seven patients of NASH were studied for the presence of hyperbilirubinemia at presentation. All patients were worked up for the presence of cirrhosis and hemolytic work up and fasting test were done in those found with unconjugated hyperbilirubinemia.
  
  
  RESULTS
  Five out of 67 patients (7.5%) of NASH were found to have unconjugated hyperbilirubinemia. Though the fasting test was not positive, they all had a negative hemolytic workup and none of them had underlying cirrhosis. Clinical characteristics of patients with unconjugated hyperbilirubinemia were similar to those with normal serum bilirubin levels.
  
  
  CONCLUSIONS
  Unconjugated hyperbilirubinemia in patients with NASH may suggest an associated Gilbert's syndrome.
authors.affiliation: Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
authors.forename: Ajay
authors.initials: A
authors.lastname: Duseja
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.forename: Reena
authors.initials: R
authors.lastname: Das
authors.forename: R K
authors.initials: RK
authors.lastname: Dhiman
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Chawla
authors.forename: A
authors.initials: A
authors.lastname: Bhansali
mesh_terms: D000328:Adult; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D005878:Gilbert Disease / Q000175:diagnosis; D006505:Hepatitis / Q000150:complications*; D006801:Humans; D006932:Hyperbilirubinemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged