Gilbert syndrome is a common inherited disorder that causes mild jaundice due to decreased activity of the liver enzyme that conjugates bilirubin, leading to increased unconjugated bilirubin levels. Episodes of jaundice are typically provoked by stress and the condition is diagnosed through increased indirect bilirubin levels with normal liver and blood tests. Treatment is not required as Gilbert syndrome is benign.

1. Gilbert syndrome
Epidemiology • Most common inherited disorder of bilirubin metabolism
Pathogenesis
• ↓ Hepatic UDP glucuronosyltransferase activity → ↓ conjugation
of bilirubin
Clinical findings
• Recurrent episodes of mild jaundice
• Provoked by stress (eg, febrile illness, fasting, dehydration,
vigorous exercise, menstruation, surgery)
Diagnosis
• ↑ Unconjugated bilirubin (ie, indirect hyperbilirubinemia)
• Normal CBC, blood smear, reticulocyte count
• Normal AST, ALT, alkaline phosphatase
Treatment • Benign; no treatment required