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A benign, inherited syndrome, in which mild, intermittent unconjugated hyperbilirubinemia occurs in the absence of hemolysis or liver dysfunction
Rare for the disorder to be diagnosed before puberty
The relative fasting that may occur with morning sickness can elevate bilirubin level.
Prevalence in the United States: ~8% of the population; ~1 in 3 of those affected are not aware that they have the disorder.
Indirect hyperbilirubinemia in Gilbert syndrome (GS) results from impaired hepatic bilirubin clearance (~30% of normal) due to decreased levels of the enzyme uridine diphosphoglucuronate-glucuronosyltransferase (UDPGT). Hepatic bilirubin conjugation (glucuronidation) is thus reduced, although this may not be the only defect.Genetics
GS is part of a spectrum of hereditary disorders that includes types I and II Crigler-Najjar syndrome (1). However, bilirubin levels in these cases will be >6 mg/dL.