title: Association of hereditary elliptocytosis and Gilbert's syndrome as the cause of biliary calculosis: case report.
abstract: BACKGROUND
  Biliary calculosis is rare in children. It occurs associated with different haemolytic and non-haemolytic disorders, which are sometimes also combined.
  
  
  METHODS
  A 15-year-old male was hospitalized due to biliary calculosis and non-conjugated hyperbilirubinemia. A mild non-conjugated hyperbilirubinemia, without anaemia and other symptoms of liver dysfunction, was registered at age 8 years, and 7 years later cholelithiasis with transitory choledocholithiasis. The finding of ellyptocytes in blood smear, which was also verified in mother, normal haemoglobin count and the absence of diseases followed by secondary dysmorphic erythrocytes of this type, indicated a clinically milder (compensated) hereditary ellyptocytosis, while more than a double increase of non-conjugated serum bilirubin fracture after a three-day hypocaloric diet (400 kcal per day) showed the concurrent presence of Gilbert's syndrome. In the laparascopically removed gallbladder a larger number of small pigmented calculi were disclosed.
  
  
  CONCLUSIONS
  Gilbert's syndrome is an essential precipitating factor of biliary calculosis in patients with chronic haemolytic condition. Thus, in all cases of biliary calculosis and non-conjugated hyperbilirubinemia with absent clinical and laboratory parameters of liver disorders and anaemia, except in compensated haemolytic disease and Gilbert's syndrome as isolated disorders, a possibility of their association should be taken into consideration.
authors.affiliation: University Children's Hospital, Belgrade, Serbia. n.radlovic@beotel.net
authors.forename: Nedeljko
authors.initials: N
authors.lastname: Radlović
authors.forename: Dragana
authors.initials: D
authors.lastname: Ristić
authors.forename: Radivoj
authors.initials: R
authors.lastname: Brdar
authors.forename: Nenad
authors.initials: N
authors.lastname: Janić
authors.forename: Zoran
authors.initials: Z
authors.lastname: Leković
authors.forename: Dragana
authors.initials: D
authors.lastname: Janić
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Smoljanić
authors.forename: Lidija
authors.initials: L
authors.lastname: Dokmanović
authors.forename: Miodrag
authors.initials: M
authors.lastname: Jovanovć
mesh_terms: D000293:Adolescent; D002769:Cholelithiasis / Q000209:etiology*; D004612:Elliptocytosis, Hereditary / Q000150:complications* / Q000175:diagnosis; D005878:Gilbert Disease / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications; D008297:Male