Gilbert Syndrome in Pregnancy: A Case Report
Abstract
Gilbert syndrome is a rare condition and rarely diagnosed before pregnancy. A 36 weeks pregnant female presented with severe vomiting, nausea, myalgia, abdominal pain, headache and yellowish discoloration of sclera, yellowish discoloration of skin since four days. She gave history of similar complaints at 16 & 24 weeks in this pregnancy and was treated conservatively with IV fluids. She have similar episodes in second pregnancy. When she was investigated, she came out to a case of Gilbert syndrome which is a rare case. So she was examined and investigated thoroughly to prepare a case report to publish. To conclude when any patient presents with unconjugated hyperbilirubinaemia associated with stress, infection or dehydration Gilbert Syndrome must be excluded. Once this diagnosis is made patient must be reassured of its benign nature, excellent prognosis and normal life expectancy.
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Introduction
Gilbert Syndrome is a benign and often familial condition characterized by recurrent mild unconjugated hyperbilirubinaemia in the absence of haemolysis or underlying liver diseases. Augustine Gilbert and Pierre Lerebullet first described Gilbert syndrome in 1901. Although various investigators have used other names for this disorder, such as constitutional hepatic dysfunction, hereditary haemolytic bilirubinaemia, and familial nonhaemolytic jaundice, Gilbert syndrome is the most commonly used name for this condition. 1
Gilbert syndrome is rarely diagnosed before puberty though it is a congenital disorder. Hormonal changes of puberty have been suggested as one explanation. 2 Dehydration, Fasting ,Exercise, Menstruation, non eating or stress precipitates Gilbert syndrome. 3 It is found in 7% of general population. 4 It is common among men than women in the ratio of 2-7:1. 5 The hyperbilirubinaemia is mild and by definition < 6mg/dL.
This case is reported for its rare incidence in pregnancy and its typical clinical features with which the patient presented.
Conclusion
This Gilbert Syndrome case is reported for its rare incidence in pregnancy and its typical clinical features with which the patient presented. To conclude when any patient presents with unconjugated hyperbilirubinaemia associated with stress,infection or dehydration Gilbert Syndrome must be excluded. Once this diagnosis is made patient must be reassured of its benign nature, excellent prognosis and normal life expectancy.