Incidence and Risk of Gallstone Disease in Gilbert's Syndrome Patients in Indian Population

Bale, Gemma; Avanthi, Urmila Steffie; Padaki, Nagaraja Rao; Sharma, Mithun; Duvvur, NR; Vishnubhotla, V.Ravi Kanth

doi:10.1016/j.jceh.2017.12.006

Cited by 16 publications

(14 citation statements)

References 27 publications

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“…However, increased prevalence of GS with GSD was found among middle aged male patients in our study. This is in accordance with literature, which supports GS as predominantly affecting middle aged males [7], [19]. When GSD is associated with hyperbilirubinemia, they usually require further evaluation with MRCP or EUS to rule out choledocholithiasis, malignancy or underlying liver disease.…”

Section: Discussionsupporting

confidence: 91%

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Gallstone Disease With Unconjugated Hyperbilirubinemia: Clinical Approach to Gilbert’s Syndrome

Kumar

Jha

Pandey

et al. 2019

JSS

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Gallstones are the commonest ailment affecting the hepato-biliary system. Associated jaundice is usually direct, commonly due to biliary obstructive lesions. Unconjugated hyperbilirubinemia with cholelithiasis is commonly seen with hemolytic disease. In the absence of hemolysis or systemic causes, congenital causes prevail, commonest of which is Gilbert’ Syndrome. This study aims to ascertain a clinical approach to the patient of gallstones with Gilbert’s syndrome. This is retrospective study of 58 patients with gallstone associated unconjugated hyperbilirubinemia, who underwent surgery over a two-year period. Patients underwent repeat blood investigations and ultrasound to confirm the diagnosis. Obstructive biliary pathology was ruled out by MRCP images; EUS added if indicated. The remaining patients underwent genetic test for Gilbert’s syndrome – namely UGT1A1 gene assessment by PCR. All patients underwent laparoscopic cholecystectomy as routine; with addition of intra-operative liver biopsy. Sixteen of the 58 patients were short-listed to be high risk factors for harboring Gilbert’s syndrome after ruling out other systemic causes. On gene study, 14 patients tested positive for UGT1A1 gene, hence Gilbert’s syndrome. The other two were kept on follow up for jaundice recurrence in future. The management algorithm is depicted as flowchart. Gilbert’s syndrome can be identified in select “high-risk” individuals presenting with gallstone disease. Genetic testing is gold standard, and helps in effective management and better patient counselling.

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Section: Discussionsupporting

confidence: 91%

“…It is not an uncommon condition with a worldwide prevalence rate between 4% and 16% [5]; with about 7.4% prevalence in northern India [6]. In a recent report, the incidence of cholelithiasis in GS was determined to by 8.9%, with a slight male preponderance (9.0% vs 7.1%) [7].…”

Section: Discussionmentioning

confidence: 99%

Gallstone Disease With Unconjugated Hyperbilirubinemia: Clinical Approach to Gilbert’s Syndrome

Kumar

Jha

Pandey

et al. 2019

JSS

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“…GS is caused by a mutation in the UGT1A1 gene resulting in impairment of glucuronidation of unconjugated bilirubin within hepatocytes. Several studies have reported the coexistence of GS and hereditary spherocytosis, G6PD deficiency, gallstone disease and other diseases ( 8 , 18 , 19 ). The reports were summarized in Table II for UGT1A1 genetic mutations and related diseases during the past 4 years.…”

Section: Discussionmentioning

confidence: 99%

Gilbert syndrome with systemic lupus erythematosus presenting with persistent unconjugated hyperbilirubinemia: A case report

Zhou

Gong

et al. 2020

Exp Ther Med

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Gilbert syndrome (GS) is a hereditary unconjugated hyperbilirubinemia that results from mutations in the bilirubin uridine diphosphate-glucuronosyltransferase (UGT1A1) gene. To the best of our knowledge, there are currently no reports that focus on patients with systemic lupus erythematosus (SLE) coexisting with GS. The present study aimed to evaluate the clinical characteristics and genotype of UGT1A1 in a Chinese patient with SLE and GS. Complete medical records and laboratory data were reviewed for a patient with SLE referred to Ruijin Hospital (Shanghai, China) for treatment between March 2016 and January 2020. Genetic analysis of the UGT1A1 gene was performed by PCR amplification and Sanger sequencing. The serum total bilirubin and unconjugated bilirubin concentrations on admission were 96.2 and 86.8 µmol/l, respectively. The homozygous mutation c.1456T>G (p.Y486D) in exon 5 was detected in this patient. The patient had a good response to phenobarbital orally at a dose of 30 mg/day and a decrease in serum bilirubin was observed. Elevated unconjugated hyperbilirubinemia in SLE needs to be differentiated from other diseases, such as GS, which can be diagnosed by UGT1A1 genetic sequencing.

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“…Prolonged post ERCP jaundice has been reported as a rare complication due to the toxicity of contrast agent, and a few cases are known in children. 2 We report a case of GS patient prolonged hyperbilirubinemia after gallstone removal due to ERCP and MRCP from the contrast agent gadoterate and iopromide.…”

Section: Introductionmentioning

confidence: 98%

“…1 And there is increased risk for cholelithiasis in patient with GS. 2 Endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreaticography (MRCP) are diagnostic tools for the cholelithiasis, and the major complications of ERCP are acute pancreatitis, sepsis, bleeding and perforation. Prolonged post ERCP jaundice has been reported as a rare complication due to the toxicity of contrast agent, and a few cases are known in children.…”

Section: Introductionmentioning

confidence: 99%

Prolonged Hyperbilirubinemia after Contrast Use in a 16-Year-Old Boy with Gilbert's Syndrome: A Case Report and Literature Review

Shin¹,

Shin²,

Han³

et al. 2021

Korean J Pancreas Biliary Tract

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Incidence and Risk of Gallstone Disease in Gilbert's Syndrome Patients in Indian Population

Cited by 16 publications

References 27 publications

Gallstone Disease With Unconjugated Hyperbilirubinemia: Clinical Approach to Gilbert’s Syndrome

Gallstone Disease With Unconjugated Hyperbilirubinemia: Clinical Approach to Gilbert’s Syndrome

Gilbert syndrome with systemic lupus erythematosus presenting with persistent unconjugated hyperbilirubinemia: A case report

Prolonged Hyperbilirubinemia after Contrast Use in a 16-Year-Old Boy with Gilbert's Syndrome: A Case Report and Literature Review

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