Gilbert's syndrome (SJ) relates to geneticdiseases and leads to disruption of bilirubin metabolism that can induce benign unconjugated hyperbilirubinemia. Exchange bilirubin is broken due to lack of glucuronyl - specific liver enzyme. This provokes a rise in the level of unbound bilirubin in the blood and the appearance of jaundice. During pregnancy, Gilbert syndrome usually no threat to the fetus. The presence of SF increases the risk of developing gallstones.
Symptoms of Gilbert's syndrome
Symptoms of Gilbert's syndrome manifested more clearlyunder the influence of stress, physical stress, malnutrition, and after viral diseases due to the use of alcohol and certain medications. For Gilbert's disease is characterized by:
- yellowing of the sclera and mucous varying degrees (yellowness of the skin is not always observed);
- pain in the liver;
- elevated levels of bilirubin in the blood;
- violation of work and painful stomach digestion.
Gilbert's syndrome is a congenital, thencase symptoms appear between the ages of 12 to 30 years. The second type of syndrome - postgepatitnaya hyperbilirubinemia, which manifests itself after suffering a viral hepatitis. In the second case you need to make a differential diagnosis, not to be confused with chronic hepatitis SJ.
Diagnosis of Gilbert's syndrome
To carry out diagnostic studies andplanning remedial measures must apply to the therapist, genetics, hematology and gastroenterology (hepatologist). If you suspect that Gilbert's syndrome, in addition to history and physical examination, the following diagnostic methods are assigned:
- Complete blood count - when SJ observed increase in hemoglobin (> 160 g / L) may reduce the appearance of retikulezah and osmotic resistance of red blood cells.
- Biochemical analysis of blood - bilirubin canup to 6 mg / dL, but generally does not pass the boundary 3 mg / dL. The parameters that determine liver function remained normal. Alkaline phosphatase may rise.
- PCR - a genetic marker SJ - the number of TA repeats in the promoter of the gene UGT1A1 chain.
- Ultrasound gallbladder and duodenal sounding - nearly all patients with SJ observed changes in biochemical composition of bile.
- Liver biopsy - possible pathological changes in the body.
- Test with starvation - in the presence of SF malnutrition leads to increased bilirubin in blood serum.
- Test with phenobarbital - the use of phenobarbital in the background of SF helps to reduce the level of unconjugated bilirubin.
- Test with nicotinic acid at SJ provokes elevation of unconjugated bilirubin. The same reaction occurs upon administration of rifampicin.
Your doctor may order additional studies and carrying out differential diagnosis with other SJ hyperbilirubinemia.
Treatment of Gilbert's disease
The forecast is quite favorable, due to the fact thatGilbert's disease is relatively safe and does not require special treatment (which is more of an everyday nature). Therapy is based on an adherence to a normal diet, work and rest. During exacerbations need to follow a diet number 5 (rejection of fatty and fried foods, alcohol), take vitamins and cholagogue. The therapist may prescribe gepatoprotektorov course. It is important to remember that it is not necessary to resort to a warm physiotherapy. SJ Treatment is aimed at restoring normal levels of uridine diphosphate-glucuronyl (liver enzyme) and the patient's general state of health stabilization.
It is necessary to consult a physician andhepatologist, what drugs can be used against a background of Gilbert's syndrome, but from what would have to give (eg, anabolic steroids, steroids, caffeine and paracetamol may enhance the manifestation of jaundice).