title: Unusual presentation of Gilbert disease with high levels of unconjugated bilirubin. Report of two cases.
abstract: Gilbert's syndrome is a benign condition characterized by asymptomatic sporadic episodes of jaundice, due to a mild unconjugated hyperbilirubinemia caused by a deficiency in bilirubin glucoronidation. Under certain physiologic or pathologic events bilirubin level rises but according to literature it does not reach out more than 3 mg/dl. We report 2 cases of Gilbert's syndrome, genetically tested, which presented with bilirubin levels above 6 mg/dl without any trigger or coexisting condition. In conclusion, bilirubin levels higher than 6 mg/dL in Gilbert syndrome are rare, hemolytic and other metabolism diseases must be ruled out, and genetic testing may be necessary in some cases.
authors.affiliation: Liver Disease Unit, Hospital San Jose - Tecnologico de Monterrey, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Flores-Villalba
authors.affiliation: Liver Disease Unit, Hospital San Jose - Tecnologico de Monterrey, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Montalvo
authors.affiliation: Liver Disease Unit, Hospital San Jose - Tecnologico de Monterrey, Mexico.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bosques-Padilla
authors.affiliation: Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Mexico.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Arredondo-Saldaña
authors.affiliation: Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Mexico.
authors.forename: Tania
authors.initials: T
authors.lastname: Zertuche-Maldonado
authors.affiliation: Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Mexico.
authors.forename: Landy
authors.initials: L
authors.lastname: Torre-Flores
mesh_terms: D000293:Adolescent; D001663:Bilirubin / Q000097:blood*; D005820:Genetic Testing; D005878:Gilbert Disease / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics; D008297:Male; D055815:Young Adult
chemical_list: D001663:Bilirubin