About unconjugated benign bilirubinemia

What is unconjugated benign bilirubinemia?

Gilbert syndrome is a mild genetic liver disorder in which the body cannot properly process bilirubin, a yellowish waste product that is formed when old or worn out red blood cells are broken down (hemolysis). Individuals with Gilbert syndrome have elevated levels of bilirubin (hyperbilirubinemia), because they have a reduced level of a specific liver enzyme required for elimination of bilirubin. Most affected individuals have no symptoms (asymptomatic) or may only exhibit mild yellowing of the skin, mucous membranes, and whites of the eyes (jaundice). Jaundice may not be apparent until adolescence. Bilirubin levels may increase following stress, exertion, dehydration alcohol consumption, fasting, and/or infection. In some individuals, jaundice may only be apparent when triggered by one of these conditions. Gilbert syndrome is inherited as an autosomal recessive trait.

What are the symptoms for unconjugated benign bilirubinemia?

The most frequent sign is an occasional yellowish tinge of the skin and the Whites of the eyes as a result of the slightly elevated levels of bilirubin in the blood. Bilirubin levels may increase and Jaundice may become apparent because of:

  • Illness, such as a cold or the flu
  • Fasting or eating a very low-calorie diet
  • Dehydration
  • Menstruation
  • Stress
  • Strenuous exercise
  • Lack of sleep

What are the causes for unconjugated benign bilirubinemia?

An abnormal gene you inherit from your parents causes Gilbert's syndrome. The gene normally controls an enzyme that helps break down bilirubin in your liver. When you have an ineffective gene, your blood contains excess amounts of bilirubin because your body doesn't produce enough of the enzyme.

How the body normally processes bilirubin

Bilirubin is a yellowish pigment made when your body breaks down old red blood cells. Bilirubin travels through your bloodstream to the liver, where the enzyme breaks down the pigment and removes it from the bloodstream.

The bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. A small amount of bilirubin remains in the blood.

How the abnormal gene is passed through families

The abnormal gene that causes Gilbert's syndrome is common. Many people carry one copy of this gene. In most cases, two abnormal copies are needed to cause Gilbert's syndrome.

What are the treatments for unconjugated benign bilirubinemia?

Gilbert's syndrome doesn't require treatment. The bilirubin levels in your blood may fluctuate over time, and you may occasionally have jaundice, which usually resolves on its own with no ill effects.

What are the risk factors for unconjugated benign bilirubinemia?

Although it's present from birth, Gilbert's syndrome usually isn't noticed until puberty or later, since bilirubin production increases during puberty. You have an increased risk of Gilbert's syndrome if:

  • Both your parents carry the abnormal gene that causes the disorder
  • You're male

Is there a cure/medications for unconjugated benign bilirubinemia?

Normal liver function tests, high bilirubin levels, and genetic testing are all necessary for the diagnosis of unconjugated benign bilirubinemia to confirm the condition. The use of drugs to treat this syndrome is not justified because of how benign and unimportant it is.

When using medications that are conjugated by the liver, such as acetaminophen and irinotecan, there is an increased risk of side effects and toxicity. There is evidence that phenobarbital can restore normal bilirubin levels.

Cure or Medication for unconjugated benign bilirubinemia

Mild unconjugated benign bilirubinemia typically goes away on its own within a few weeks without the need for medication. The treatment used to treat the severe condition is:


1. Phototherapy is a secure treatment option in cases of moderate or severe unconjugated benign bilirubinemia (TB above 15 mg/dL).
2. During phototherapy, the infant's prolonged exposure to light in the blue-green spectrum (460-490 nm) in such a way that bilirubin is converted into lumirubin, a water-soluble isomer, and its toxicity is decreased by raising its excretion in both the urine and stool.
3. During phototherapy, it's critical to keep up a healthy level of hydration and urine production. UV rays (400 nm) in unfiltered sunlight increase the risk of sunburn and skin cancer. Therefore, phototherapy does not use sunlight that has not been filtered.

Dehydration,Menstruation,Strenuous exercise,Stress,Dark-colored urine or clay-colored stool,Difficulty concentrating,Dizziness,Gastrointestinal problems, such as abdominal pain, diarrhea, and nausea,Fatigue,Flu-like symptoms, including fever and chills,Loss of appetite
Fatigue,Stomach ache
Phototherapy (in severe cases)

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