Don’t mistake Gilbert’s syndrome for viral hepatitis

Chen, male, 38 years old, Yanling County, Hunan Province, was hospitalized in our center for 1.5 years due to recurrent body and eye urine yellowing. Previously, similar scleral yellowing appeared at the age of 20. During the onset of the disease, liver function was checked several times: TBIL fluctuated between 105-382 μmol/L, and all of them were unconjugated bilirubin, and Hepatitis B VI: HBsAg positive. He was hospitalized in Yiling local hospital and Changsha big hospitals, and was treated according to severe hepatitis, which cost tens of thousands of dollars, but was ineffective. She was diagnosed as type II Gilbert’s syndrome after one week of diagnostic treatment with sodium phenobarbital enzyme-inducing therapy and liver puncture biopsy in our center. After supplementation of enzyme inducer, liver protection and treatment with traditional Chinese medicine for more than 1 month, TBIL decreased to 38.2 μmol /L and was successfully discharged from the hospital. The patient’s condition has been stabilized without any recurrence since the follow-up. Gilbert’s syndrome: It is a hereditary non-conjugated bilirubin level increase, resulting in bilirubin excretion obstacle, but liver function is normal, is the most common type of syndrome in human beings. It is the most common form of the syndrome in humans. It is mainly caused by genetic defects that result in impaired bilirubin uptake, transport, binding, or excretion by hepatocytes. Except for a few cases of increased unconjugated bilirubin that may cause nuclear jaundice, the common manifestations are familial, chronic, non-hemolytic, intermittent jaundice with mild or no symptoms, generally good health, and a good prognosis.Patients with type I Gilbert’s syndrome are predominantly adolescents, with a high prevalence of males. The bilirubin concentration is <85.5 μmol /L, mainly unconjugated bilirubin. Patients with type I Gilbert syndrome are mainly adolescents and males, with bilirubin concentration <85μmol /L, mainly unconjugated bilirubin. Most of them have no conscious symptoms or only complain of fatigue, liver discomfort, etc. Other liver functions are normal. type II Gilbert syndrome, i.e., post-hepatitis syndrome: cryptogenic Gilbert syndrome. Serum TBIL is mostly between 170-340 μmol/L, which is unconjugated bilirubin, and other liver function tests are normal. Self-perceived symptoms are mild.Jaundice in Gilbert's syndrome may fluctuate and may be increased by fever, overwork, and alcohol consumption, but may resolve with rest. The disease does not have and does not require specific treatment. And the prognosis is good, it will not be transformed into chronic hepatitis, cirrhosis, liver cancer and so on.