788:
cancers, diabetes, and neurodegenerative disorders. However, the mechanisms and pathways of bilirubin protection are not fully elucidated, and the optimal level and range of bilirubin are unknown. The genetic and environmental factors that influence UGT1A1 expression and activity are also poorly characterized and may affect the variability and penetrance of GS. Despite the fact that hyperbilirubinemia in GS is associated with reduced incidence of cardiovascular diseases, diabetes, and metabolic syndrome, the clinical significance and implications of these GS research findings are unclear, and can not yet be translated into preventive or therapeutic strategies.
449:. But scientific studies found no clear pattern of adverse symptoms related to the elevated levels of unconjugated bilirubin in adults. However, other substances glucuronidized by the affected enzymes in those with Gilbert's syndrome could theoretically, at their toxic levels, cause these symptoms. Consequently, debate exists about whether GS should be classified as a disease. However, Gilbert syndrome has been linked to an increased risk of
44:
779:
affect the expression or activity of the UGT1A1 enzyme that is responsible for bilirubin conjugation. However, these studies had limitations, such as the small sample size, the lack of a standardized definition of GS, the possible confounding factors of diet, lifestyle, and medication use, and the cross-sectional and observational design that does not allow for causal inference.
787:
Ongoing studies suggest that mild hyperbilirubinaemia in GS may have beneficial effects, probably due to the antioxidant and anti-inflammatory properties of bilirubin. Hyperbilirubinaemia in GS may protect against oxidative stress and inflammation-related diseases, such as cardiovascular diseases,
355:
The mild increase in unconjugated bilirubin due to
Gilbert syndrome is closely related to the reduction in the prevalence of chronic diseases, especially cardiovascular disease and type 2 diabetes, related risk factors, and all-cause mortality. Observational studies emphasize that the antioxidant
480:
is transferred to unconjugated bilirubin, which is a yellowish pigment made when your body breaks down old red blood cells, and then being converted to conjugated bilirubin during the reaction. Conjugated bilirubin passes from the liver into the intestines with bile. It's then excreted in stool.
778:
Studies conducted so far suggest that subjects with GS may have lower levels of vitamin D and folic acid than control subjects, having these levels inversely correlated with bilirubin levels. It may be that GS may impair the metabolism or absorption of these vitamins, or that these vitamins may
1555:
Kohle C, Mohrle B, Munzel PA, Schwab M, Wernet D, Badary OA, Bock KW (2003). "Frequent co-occurrence of the TATA box mutation associated with
Gilbert's syndrome (UGT1A1*28) with other polymorphisms of the UDP-glucuronosyltransferase-1 locus (UGT1A6*2 and UGT1A7*3) in Caucasians and Egyptians".
632:
is usually within the normal range or is less than 20% of the total. Levels of bilirubin in GS patients are reported to be from 20 ÎŒM to 90 ÎŒM (1.2 to 5.3 mg/dl) compared to the normal amount of < 20 ÎŒM. GS patients have a ratio of unconjugated/conjugated (indirect/direct) bilirubin
262:
may be used, which aids in the conjugation of bilirubin. Gilbert syndrome affects about 5% of people in the United States. Males are more often diagnosed than females. It is often not noticed until late childhood to early adulthood. The condition was first described in 1901 by
484:
People with
Gilbert syndrome have approximately 30 percent of normal bilirubin-UGT enzyme function, which contributes to a lower rate of glucuronidation of unconjugated bilirubin. This substance then accumulates in the body, causing mild hyperbilirubinemia.
663:
While
Gilbert syndrome is considered harmless, it is clinically important because it may give rise to a concern about a blood or liver condition, which could be more dangerous. However, these conditions have additional indicators:
288:
may appear under conditions of exertion, stress, fasting, and infections, but the condition is otherwise usually asymptomatic. Severe cases are seen by yellowing of the skin tone and yellowing of the conjunctiva in the eye.
375:(hardening of the arteries) in subjects with GS had a close and inverse relationship to the serum bilirubin. This beneficial effect was attributed to bilirubin IXα which is recognized as a potent antioxidant, rather than
296:. The syndrome cannot cause severe indirect hyperbilirubinemia in neonates by itself, but it may have a summative effect on rising bilirubin when combined with other factors, for example in the presence of increased
3205:
3190:
2288:
Raijmakers MT, Jansen PL, Steegers EA, Peters WH (2000). "Association of human liver bilirubin UDP-glucuronyltransferase activity, most commonly due to a polymorphism in the promoter region of the UGT1A1 gene".
686:(types I and II), a different glucuronyl transferase disorder, is much more severe, with 0â10% UGT1A1 activity, with affected individuals at risk of brain damage in infancy (type I) and teenage years (type II).
347:(acetaminophen) is not metabolized by UGT1A1, it is metabolized by one of the other enzymes also deficient in some people with GS. A subset of people with GS may have an increased risk of paracetamol toxicity.
366:
Specifically, people with mildly elevated levels of bilirubin (1.1 mg/dl to 2.7 mg/dl) were at lower risk for CAD and at lower risk for future heart disease. These researchers went on to perform a
589:
However, Gilbert syndrome can arise without TATA box promoter polymorphic variants; in some populations, particularly healthy
Southeast and East Asians, Gilbert's syndrome is more often a consequence of
1354:
497:
effect, mostly associated with increased blood bilirubin levels, but also sometimes characterized by mild jaundice due to increased unconjugated bilirubin, that arises from several different
1032:
Bulmer, A. C.; Verkade, H. J.; Wagner, K.-H. (April 2013). "Bilirubin and beyond: a review of lipid status in
Gilbert's syndrome and its relevance to cardiovascular disease protection".
1941:
Kundur, Avinash R.; Singh, Indu; Bulmer, Andrew C. (March 2015). "Bilirubin, platelet activation and heart disease: a missing link to cardiovascular protection in
Gilbert's syndrome?".
2008:
Olsson R, Bliding A, Jagenburg R, Lapidus L, Larsson B, SvĂ€rdsudd K, Wittboldt S (1988). "Gilbert's syndromeâdoes it exist? A study of the prevalence of symptoms in
Gilbert syndrome".
2892:
After visiting specialists in his native
Germany, Folger has been diagnosed with Gilbert's syndrome â a genetic ailment that precludes the liver from correctly processing bilirubin.
567:; this common variant accounts for about 40% of alleles in some populations, but is seen less often, around 3% of alleles, in Southeast and East Asian people and Pacific Islanders.
37:
Gilbert syndrome, Meulengracht syndrome, Gilbert-Lereboullet syndrome, hyperbilirubinemia Arias type, hyperbilirubinemia type 1, familial cholemia, familial nonhemolytic jaundice
2249:
2880:
640:
for two days, and a fast can, therefore, be useful diagnostically. A further conceptual step that is rarely necessary or appropriate is to give a low dose of
1332:
466:
228:
2368:
Monaghan G, Ryan M, Seddon R, Hume R, Burchell B (1996). "Genetic variation in bilirubin UPD-glucuronosyltransferase gene promoter and
Gilbert's syndrome".
2130:
3014:
321:
2962:
1769:
Ladislav NovotnĂœc; Libor VĂtek (2003). "Inverse Relationship Between Serum Bilirubin and Atherosclerosis in Men: A Meta-Analysis of Published Studies".
1175:
1865:
VĂtek L; Jirsa M; BrodanovĂĄ M; et al. (2002). "Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels".
719:
associated with increase of conjugated bilirubin can be excluded by negative blood samples for antigens specific to the different hepatitis viruses.
2850:
927:
398:
genotype were associated with one-third the risk for both coronary heart disease and cardiovascular disease as compared to those with the (TA)
1814:"Gilbert syndrome, UGT1A1*28 allele, and cardiovascular disease risk: possible protective effects and therapeutic applications of bilirubin"
612:
Because of its effects on drug and bilirubin breakdown and because of its genetic inheritance, Gilbert's syndrome can be classed as a minor
413:(mean platelet volume) are decreased in patients with Gilbert's syndrome. The elevated levels of bilirubin and decreasing levels of MPV and
3326:
1520:
Rauchschwalbe S, Zuhlsdorf M, Wensing G, Kuhlmann J (2004). "Glucuronidation of acetaminophen is independent of UGT1A1 promotor genotype".
2927:
2327:
Bosma PJ; Chowdhury JR; Bakker C; Gantla S; de Boer A; Oostra BA; Lindhout D; Tytgat GN; Jansen PL; Oude Elferink RP; et al. (1995).
258:
Typically no treatment is needed. Gilbert syndrome is associated with decreased cardiovascular health risks. If jaundice is significant
2790:
2188:
966:
469:(bilirubin-UGT) enzyme, which can be found in the liver cells and is responsible for preparing bilirubin for removal from the body.
2270:
2955:
696:
levels, and the absence of reticulocytosis (elevated reticulocytes in the blood would usually be observed in haemolytic anaemia).
2241:
2220:
1007:
2274:
2808:
2548:"The frequency, clinical course, and health related quality of life in adults with Gilbert's syndrome: a longitudinal study"
1450:
2524:
2131:"Coinheritance of Gilbert syndrome increases the risk for developing gallstones in patients with hereditary spherocytosis"
1118:
3220:
2086:
Larissa K. F. Temple; Robin S. McLeod; Steven Gallinger; James G. Wright (2001). "Defining Disease in the Genomics Era".
3336:
2948:
2166:
1745:
2865:
1902:"Association between the UGT1A1*28 allele, bilirubin levels, and coronary heart disease in the Framingham Heart Study"
95:
1414:
3048:
1841:
2329:"The genetic basis of the reduced expression of bilirubin UDP-glucuronosyltransferase 1 in Gilbert's syndrome"
1989:
17:
3097:
3083:
2915:
1247:
Bancroft JD, Kreamer B, Gourley GR (1998). "Gilbert syndrome accelerates development of neonatal jaundice".
239:
pattern depending on the type of variant. Episodes of jaundice may be triggered by stress such as exercise,
3019:
1167:
872:
3132:
3127:
2546:
Kamal S, Abdelhakam S, Ghoraba D, Massoud Y, Aziz KA, Hassan H, Hafez T, Abdel Sallam A (February 2019).
683:
162:
609:) in the actual gene coding region, which may be associated with significantly higher bilirubin levels.
3341:
3152:
2842:
699:
613:
170:
3068:
652:
3231:
2989:
2826:
2742:"Constitutional hepatic dysfunction (Gilbert's disease): its natural history and related syndromes"
1198:"Prevalence of Gilbert syndrome in parents of neonates with pathologic indirect hyperbilirubinemia"
919:
797:
380:
264:
2649:
Gorbunova O, Chernysheva E (November 2019). "A New Look at Gilbert Syndrome (Literature Review)".
2085:
1594:
Esteban A, PĂ©rez-Mateo M (1999). "Heterogeneity of paracetamol metabolism in Gilbert's syndrome".
1331:
Usman, Fatima; Diala, Udochukwu; Shapiro, Steven; Le Pichon, Jean-Baptiste; Slusher, Tina (2018).
3044:
801:
745:
360:
137:
2800:
2794:
2924:
2212:
1473:"UGT1A1 gene variations and irinotecan treatment in patients with metastatic colorectal cancer"
856:
749:
673:
625:
552:
531:(where n is the general chronological order of discovery), either of the gene itself or of its
501:
variants of the gene for the enzyme responsible for changing bilirubin to the conjugated form.
387:
244:
157:
3282:
2146:
445:, abdominal pain, loss of weight, itching (with no rash), and others, such as humor change or
2413:"Effect of dietary composition on the unconjugated hyperbilirubinaemia of Gilbert's syndrome"
730:
693:
1284:"The interaction between Gilbert's syndrome and G6PD deficiency influences bilirubin levels"
429:
Symptoms, whether connected or not to GS, have been reported in a subset of those affected:
2180:
958:
669:
636:
The level of total bilirubin is often further increased if the blood sample is taken after
629:
520:
513:
410:
2911:
1954:
1829:
8:
3346:
3331:
3209:
3078:
1642:
1333:"Acute bilirubin encephalopathy and its progression to kernicterus: current perspectives"
862:
232:
433:(feeling tired all the time), difficulty maintaining concentration, unusual patterns of
305:
2876:
2771:
2700:
2673:
2631:
2574:
2547:
2486:
2461:
2437:
2412:
2393:
2158:
2129:
del Giudice EM, Perrotta S, Nobili B, Specchia C, d'Urzo G, Iolascon A (October 1999).
2111:
2068:
2021:
1794:
1737:
1690:
1619:
1497:
1472:
1401:
1313:
1224:
1197:
594:
414:
236:
123:
3214:
2509:
Singh, A.; Koritala, J.; Jialal, I. (20 May 2023). "Unconjugated Hyperbilirubinemia".
2381:
2302:
2056:
1918:
1901:
1878:
1569:
1260:
3242:
2985:
2804:
2763:
2758:
2741:
2705:
2654:
2635:
2623:
2579:
2516:
2491:
2442:
2385:
2350:
2306:
2150:
2103:
2060:
2025:
1966:
1958:
1923:
1882:
1833:
1786:
1729:
1682:
1611:
1573:
1537:
1502:
1442:
1406:
1392:
1305:
1300:
1283:
1264:
1229:
1067:
1059:
999:
446:
293:
150:
111:
3304:
2397:
2162:
2072:
1798:
1741:
1694:
1623:
1317:
332:
certain drugs. For example, Gilbert syndrome is associated with severe diarrhea and
3073:
2907:
Understanding Gilbert's Syndrome and living better with Gilbert's Syndrome symptoms
2775:
2753:
2695:
2685:
2613:
2569:
2559:
2481:
2473:
2432:
2424:
2377:
2340:
2298:
2142:
2115:
2095:
2052:
2017:
1950:
1913:
1874:
1825:
1778:
1721:
1672:
1603:
1565:
1529:
1492:
1484:
1396:
1388:
1344:
1295:
1256:
1219:
1209:
1083:
1081:
1049:
1041:
116:
66:
3293:
1677:
1660:
1659:
Wagner, K. H.; Shiels, R. G.; Lang, C. A.; Seyed Khoei, N.; Bulmer, A. C. (2018).
1045:
3236:
3039:
2931:
2723:
1993:
846:
716:
532:
505:
477:
473:
418:
372:
301:
2510:
2345:
2328:
1782:
1436:
1078:
3157:
2728:
2618:
2601:
1110:
703:
329:
248:
166:
3247:
3199:
2564:
668:
In GS, unless another disease of the liver is also present, the liver enzymes
543:
promoter region; this region most commonly contains the genetic sequence A(TA)
3320:
1962:
1063:
800:
and co-workers in 1901. In German literature, it is commonly associated with
762:
641:
578:
TAA alleles. In 94% of GS cases, two other glucuronosyltransferase enzymes,
556:
465:
gene lead to Gilbert Syndrome. The gene provides instructions for making the
417:
in Gilbert's syndrome patients may have an effect on the slowing down of the
368:
280:
Gilbert syndrome produces an elevated level of unconjugated bilirubin in the
259:
209:
more slowly than the majority. Many people never have symptoms. Occasionally
2940:
2099:
1725:
1282:
Cappellini MD, Di Montemuros FM, Sampietro M, Tavazzi D, Fiorelli G (1999).
1214:
304:. This situation can be especially dangerous if not quickly treated, as the
292:
Gilbert syndrome has been reported to contribute to an accelerated onset of
128:
Usually none, still, abdominal pain, nausea, tired and weak feeling, slight
2919:
2767:
2739:
2709:
2690:
2658:
2627:
2583:
2520:
2310:
2154:
2107:
1970:
1927:
1886:
1837:
1790:
1733:
1709:
1686:
1615:
1577:
1541:
1506:
1488:
1471:
Marcuello E, Altés A, Menoyo A, Del Rio E, Gómez-Pardo M, Baiget M (2004).
1446:
1410:
1309:
1233:
1071:
868:
591:
555:
of this region occur, the most common of which results from adding another
356:
effects of unconjugated bilirubin may bring survival benefits to patients.
240:
2446:
2389:
2354:
2271:"Entrez Gene: UGT1A1 UDP glucuronosyltransferase 1 family, polypeptide A1"
2029:
1268:
3277:
2495:
2477:
2428:
2043:
Bailey A, Robinson D, Dawson AM (1977). "Does Gilbert's disease exist?".
722:
376:
344:
333:
309:
221:
2064:
1376:
1349:
390:. Moderately elevated levels of bilirubin in people with GS and the (TA)
213:(a slight yellowish color of the skin or whites of the eyes) may occur.
3299:
2459:
1607:
1281:
1054:
852:
734:
571:
570:
In most populations, Gilbert syndrome is most commonly associated with
337:
3182:
3288:
3253:
3102:
2994:
2980:
2870:
2866:"Illness that 'shut down' Tech3 MotoGP rookie Jonas Folger diagnosed"
2740:
Foulk, WT; Butt, HR; Owen, CA Jr; Whitcomb, FF Jr; Mason, HL (1959).
1647:
1533:
1519:
741:
710:
707:
689:
494:
450:
297:
252:
206:
51:
2326:
1813:
2674:"Bilirubin as a Therapeutic Molecule: Challenges and Opportunities"
1986:
841:
540:
498:
438:
285:
217:
210:
129:
2906:
1899:
796:
Gilbert syndrome was first described by French gastroenterologist
3258:
2460:
N Carulli; M Ponz de Leon; E Mauro; F Manenti; A Ferrari (1976).
2128:
1088:
Gilbert A, Lereboullet P (1901). "La cholémie simple familiale".
692:
of any cause can be excluded by a full blood count, haptoglobin,
677:
637:
504:
Gilbert's syndrome is characterized by a 70â80% reduction in the
434:
430:
3225:
3194:
2508:
713:
disorders characterized by an increase of conjugated bilirubin.
583:
579:
548:
442:
2410:
2287:
1811:
782:
359:
Several analyses have found a significantly decreased risk of
308:
can cause irreversible neurological disability in the form of
84:
72:
69:
2545:
2007:
1381:
Archives of Disease in Childhood - Fetal and Neonatal Edition
761:
Typically no treatment is needed. If jaundice is significant
472:
The bilirubin-UGT enzyme performs a chemical reaction called
371:
of data available up to 2002, and confirmed the incidence of
325:
281:
202:
1768:
1661:"Diagnostic criteria and contributors to Gilbert's syndrome"
43:
2971:
2843:"A Tennis Player Learns to Be Aggressive for Health's Sake"
1658:
1470:
1377:"Learning from claims: hyperbilirubinaemia and kernicterus"
1330:
807:
Alternative, less common names for this disorder include:
386:
This association was also seen in long-term data from the
2934:
1864:
1375:
Rennie, Janet M.; Beer, Jeanette; Upton, Michele (2019).
729:
by normal levels of bile acids in plasma, the absence of
1900:
Lin JP; O'Donnell CJ; Schwaiger JP; et al. (2006).
1596:
European Journal of Drug Metabolism and Pharmacokinetics
243:, or not eating. Diagnosis is based on higher levels of
1554:
1166:
Philadelphia, The Children's Hospital of (2014-08-23).
2367:
1246:
2462:"Alteration of drug metabolism in Gilbert's syndrome"
467:
bilirubin uridine diphosphate glucuronosyltransferase
229:
bilirubin uridine diphosphate glucuronosyltransferase
96:
87:
3172:
2648:
2042:
2036:
1860:
1858:
1195:
322:
UDP glucuronosyltransferase 1 family, polypeptide A1
81:
75:
3040:
Gunther disease/congenital erythropoietic porphyria
2515:. Treasure Island, Florida: StatPearls Publishing.
1031:
78:
1593:
1087:
315:
1940:
1855:
406:genotype (i.e. a normal, nonmutated gene locus).
3318:
1665:Critical Reviews in Clinical Laboratory Sciences
1154:Davidson's Principles & Practice of Medicine
849:, Nobel laureate in Physiology or Medicine, 1959
811:Familial benign unconjugated hyperbilirubinaemia
324:(UGT1A1) â are also responsible for some of the
2595:
2593:
2207:
2205:
2185:NORD (National Organization for Rare Disorders)
1374:
963:NORD (National Organization for Rare Disorders)
817:Familial non-hemolytic non-obstructive jaundice
586:(rendered 83% ineffective), are also affected.
551:in many populations. However, several allelic
2599:
2322:
2320:
2970:
2956:
1812:Schwertner Harvey A; VĂtek Libor (May 2008).
1707:
1196:Saki, F.; Hemmati, F.; Haghighat, M. (2011).
748:counts above 90â92) can be associated with a
644:: the bilirubin will decrease substantially.
633:commensurately higher than those without GS.
559:TA to the promoter region, resulting in A(TA)
2665:
2642:
2590:
2539:
2202:
1637:
1635:
1633:
1189:
1165:
1111:"Whonamedit â dictionary of medical eponyms"
547:TAA; this variant accounts for about 50% of
2863:
2411:J L Gollan; C Bateman; B H Billing (1976).
2317:
1764:
1762:
1434:
914:
912:
910:
908:
783:The role of bilirubin in health and disease
624:People with GS predominantly have elevated
247:in the blood without either signs of other
227:which results in decreased activity of the
2963:
2949:
2840:
2824:"Wire preaches delights of three cliffs".
2242:"Gilbert's syndrome - Symptoms and causes"
2003:
2001:
1589:
1587:
1156:, 20th edition, Churchill Livingstone 2006
1141:Harrison's Principles of Internal Medicine
953:
951:
949:
947:
945:
906:
904:
902:
900:
898:
896:
894:
892:
890:
888:
733:, low levels of conjugated bilirubin, and
42:
2788:
2782:
2757:
2699:
2689:
2617:
2573:
2563:
2485:
2436:
2344:
2147:10.1182/blood.V94.7.2259.419k42_2259_2262
1917:
1676:
1630:
1496:
1400:
1348:
1299:
1223:
1213:
1105:
1103:
1053:
994:
992:
990:
988:
986:
984:
658:
350:
284:, but normally has no consequences. Mild
2263:
2213:"Gilbert syndrome: MedlinePlus Genetics"
1805:
1759:
231:enzyme. It is typically inherited in an
2799:. Greenwood Publishing Group. pp.
1998:
1584:
942:
885:
320:The enzymes that are defective in GS â
3319:
1982:
1980:
1121:from the original on 18 September 2016
1100:
981:
830:
768:
647:Tests can also detect DNA variants of
2944:
2853:from the original on 14 October 2016.
2733:
2600:VĂtek L, Tiribelli C (October 2023).
2527:from the original on 18 November 2023
1955:10.1016/j.atherosclerosis.2014.12.042
1830:10.1016/j.atherosclerosis.2008.01.001
969:from the original on 20 February 2017
508:activity of the enzyme (UGT1A1). The
270:
2864:Khorounzhiy, Valentin (2017-11-09).
2817:
2671:
1027:
1025:
823:Low-grade chronic hyperbilirubinemia
3327:Accessory digestive gland disorders
1977:
1708:King, D.; Armstrong, M. J. (2019).
1337:Research and Reports in Neonatology
13:
2022:10.1111/j.0954-6820.1988.tb19615.x
930:from the original on 4 August 2017
740:Vitamin B12 deficiency - elevated
340:, which is metabolized by UGT1A1.
205:of affected individuals processes
14:
3358:
2900:
1919:10.1161/CIRCULATIONAHA.106.633206
1771:Experimental Biology and Medicine
1435:Reddy, D. K.; Pandey, S. (2021).
1168:"Hyperbilirubinemia and Jaundice"
1022:
1010:from the original on 27 June 2017
826:Unconjugated benign bilirubinemia
773:
336:in patients who are treated with
2759:10.1097/00005792-195902000-00002
2277:from the original on 2010-12-05.
1710:"Overview of Gilbert's syndrome"
1393:10.1136/archdischild-2017-314622
1301:10.1111/j.1365-2141.1999.1331a.x
1143:, 16th edition, McGraw-Hill 2005
835:
814:Constitutional liver dysfunction
597:(such as Gly71Arg also known as
65:
2883:from the original on 2017-11-10
2857:
2834:
2716:
2502:
2453:
2404:
2361:
2333:New England Journal of Medicine
2281:
2252:from the original on 2017-11-08
2234:
2223:from the original on 2019-04-08
2191:from the original on 2017-02-20
2173:
2122:
2079:
1934:
1893:
1844:from the original on 2018-09-04
1748:from the original on 2021-05-23
1701:
1652:
1548:
1513:
1464:
1453:from the original on 2021-08-28
1428:
1417:from the original on 2020-07-15
1368:
1357:from the original on 2020-08-13
1324:
1275:
1240:
1178:from the original on 2022-02-17
316:Detoxification of certain drugs
235:pattern and occasionally in an
3049:Hepatoerythropoietic porphyria
2602:"Gilbert's syndrome revisited"
1714:Drug and Therapeutics Bulletin
1288:British Journal of Haematology
1159:
1146:
1133:
820:Icterus intermittens juvenilis
527:gene are known, designated as
363:(CAD) in individuals with GS.
1:
3098:Hereditary hyperbilirubinemia
3084:Erythropoietic protoporphyria
2382:10.1016/S0140-6736(96)91273-8
2303:10.1016/S0168-8278(00)80268-8
2057:10.1016/S0140-6736(77)92226-7
1879:10.1016/S0021-9150(01)00601-3
1678:10.1080/10408363.2018.1428526
1570:10.1016/S0006-2952(03)00074-1
1261:10.1016/S0022-3476(98)70356-7
1046:10.1016/j.plipres.2012.11.001
879:
216:Gilbert syndrome is due to a
201:) is a syndrome in which the
3020:Acute intermittent porphyria
2841:David Cox. (19 April 2014).
756:
655:or DNA fragment sequencing.
619:
582:(rendered 50% inactive) and
7:
2653:(in Russian) (296): 75â81.
2346:10.1056/NEJM199511023331802
1783:10.1177/15353702-0322805-29
680:, are within normal ranges.
488:
275:
10:
3363:
2672:Adin CA (September 2021).
2619:10.1016/j.jhep.2023.06.004
1034:Progress in Lipid Research
791:
614:inborn error of metabolism
605:, Pro364Leu also known as
601:, Tyr486Asp also known as
298:red blood cell destruction
15:
3337:Heme metabolism disorders
3268:
3176:
3141:
3111:
3096:
3069:Hereditary coproporphyria
3057:
3028:
3003:
2979:
2789:Shmaefsky, Brian (2006).
2565:10.1186/s12876-019-0931-2
1522:Int J Clin Pharmacol Ther
653:polymerase chain reaction
184:
176:
156:
146:
136:
122:
110:
57:
50:
41:
33:
28:
2937:Best Practices monograph
2830:. 2007-04-27. p. 3.
2827:South Wales Evening Post
2010:Acta Medica Scandinavica
1202:Annals of Saudi Medicine
798:Augustin Nicolas Gilbert
737:scan of the bile ducts.
456:
424:
381:high-density lipoprotein
300:due to diseases such as
265:Augustin Nicolas Gilbert
253:red blood cell breakdown
16:Not to be confused with
3133:LuceyâDriscoll syndrome
3128:CriglerâNajjar syndrome
3045:Porphyria cutanea tarda
2724:Jens Einar Meulengracht
2100:10.1126/science.1062938
1726:10.1136/dtb.2018.000028
1215:10.4103/0256-4947.77498
1004:Genetics Home Reference
802:Jens Einar Meulengracht
684:CriglerâNajjar syndrome
373:atherosclerotic disease
361:coronary artery disease
163:CriglerâNajjar syndrome
18:GuillainâBarrĂ© syndrome
3305:Gilbert's syndrome
3153:DubinâJohnson syndrome
2691:10.3390/antiox10101536
1489:10.1038/sj.bjc.6602042
857:Manic Street Preachers
750:vitamin B12 deficiency
700:DubinâJohnson syndrome
659:Differential diagnosis
626:unconjugated bilirubin
493:Gilbert syndrome is a
388:Framingham Heart Study
351:Cardiovascular effects
245:unconjugated bilirubin
171:DubinâJohnson syndrome
158:Differential diagnosis
2291:Journal of Hepatology
1249:Journal of Pediatrics
731:lactate dehydrogenase
694:lactate dehydrogenase
563:TAA, which is called
539:is associated with a
180:None typically needed
3006:early mitochondrial:
2974:metabolism disorders
2746:Medicine (Baltimore)
2478:10.1136/gut.17.8.581
2429:10.1136/gut.17.5.335
1987:GilbertsSyndrome.com
630:conjugated bilirubin
553:polymorphic variants
409:Platelet counts and
306:high serum bilirubin
3079:Variegate porphyria
3060:late mitochondrial:
1350:10.2147/RRN.S125758
1090:La Semaine MĂ©dicale
863:Alexandr Dolgopolov
831:Society and culture
769:Research directions
557:dinucleotide repeat
512:gene is located on
233:autosomal recessive
3269:External resources
3123:Gilbert's syndrome
2930:2016-05-18 at the
2925:Gilbert's Syndrome
2912:Gilbert's syndrome
2877:Motorsport Network
2181:"Gilbert Syndrome"
1992:2006-08-10 at the
1608:10.1007/BF03190005
1115:www.whonamedit.com
1000:"Gilbert syndrome"
959:"Gilbert Syndrome"
920:"Gilbert syndrome"
595:missense mutations
514:human chromosome 2
271:Signs and symptoms
237:autosomal dominant
29:Gilbert's syndrome
3342:Genetic syndromes
3314:
3313:
3170:
3169:
3166:
3165:
3092:
3091:
2810:978-0-313-33528-0
2796:Biotechnology 101
2651:Georgian Med News
2552:BMC Gastroenterol
2094:(5531): 807â808.
1558:Biochem Pharmacol
461:Mutations in the
294:neonatal jaundice
192:
191:
23:Medical condition
3354:
3174:
3173:
3146:
3116:
3109:
3108:
3074:Harderoporphyria
3062:
3033:
3008:
3001:
3000:
2965:
2958:
2951:
2942:
2941:
2895:
2894:
2889:
2888:
2861:
2855:
2854:
2838:
2832:
2831:
2821:
2815:
2814:
2786:
2780:
2779:
2761:
2737:
2731:
2720:
2714:
2713:
2703:
2693:
2669:
2663:
2662:
2646:
2640:
2639:
2621:
2612:(4): 1049â1055.
2597:
2588:
2587:
2577:
2567:
2543:
2537:
2536:
2534:
2532:
2506:
2500:
2499:
2489:
2457:
2451:
2450:
2440:
2408:
2402:
2401:
2376:(9001): 578â81.
2365:
2359:
2358:
2348:
2324:
2315:
2314:
2285:
2279:
2278:
2267:
2261:
2260:
2258:
2257:
2238:
2232:
2231:
2229:
2228:
2209:
2200:
2199:
2197:
2196:
2177:
2171:
2170:
2165:. Archived from
2126:
2120:
2119:
2088:Science Magazine
2083:
2077:
2076:
2040:
2034:
2033:
2005:
1996:
1984:
1975:
1974:
1938:
1932:
1931:
1921:
1897:
1891:
1890:
1862:
1853:
1852:
1850:
1849:
1809:
1803:
1802:
1766:
1757:
1756:
1754:
1753:
1705:
1699:
1698:
1680:
1656:
1650:
1643:Gilbert Syndrome
1639:
1628:
1627:
1591:
1582:
1581:
1552:
1546:
1545:
1534:10.5414/cpp42073
1517:
1511:
1510:
1500:
1468:
1462:
1461:
1459:
1458:
1432:
1426:
1425:
1423:
1422:
1404:
1387:(2): F202âF204.
1372:
1366:
1365:
1363:
1362:
1352:
1328:
1322:
1321:
1303:
1279:
1273:
1272:
1244:
1238:
1237:
1227:
1217:
1193:
1187:
1186:
1184:
1183:
1163:
1157:
1150:
1144:
1137:
1131:
1130:
1128:
1126:
1107:
1098:
1097:
1085:
1076:
1075:
1057:
1029:
1020:
1019:
1017:
1015:
1006:. 27 June 2017.
996:
979:
978:
976:
974:
955:
940:
939:
937:
935:
916:
379:factors such as
195:Gilbert syndrome
117:Gastroenterology
100:
94:
93:
90:
89:
86:
83:
80:
77:
74:
71:
46:
26:
25:
3362:
3361:
3357:
3356:
3355:
3353:
3352:
3351:
3317:
3316:
3315:
3310:
3309:
3264:
3263:
3185:
3171:
3162:
3142:
3137:
3112:
3100:
3088:
3058:
3053:
3029:
3024:
3004:
2992:
2984:
2975:
2969:
2932:Wayback Machine
2903:
2898:
2886:
2884:
2862:
2858:
2849:. Monte Carlo.
2839:
2835:
2823:
2822:
2818:
2811:
2787:
2783:
2738:
2734:
2721:
2717:
2670:
2666:
2647:
2643:
2598:
2591:
2544:
2540:
2530:
2528:
2507:
2503:
2458:
2454:
2409:
2405:
2366:
2362:
2325:
2318:
2286:
2282:
2269:
2268:
2264:
2255:
2253:
2240:
2239:
2235:
2226:
2224:
2217:medlineplus.gov
2211:
2210:
2203:
2194:
2192:
2179:
2178:
2174:
2127:
2123:
2084:
2080:
2051:(8018): 931â3.
2041:
2037:
2006:
1999:
1994:Wayback Machine
1985:
1978:
1943:Atherosclerosis
1939:
1935:
1912:(14): 1476â81.
1898:
1894:
1867:Atherosclerosis
1863:
1856:
1847:
1845:
1818:Atherosclerosis
1810:
1806:
1767:
1760:
1751:
1749:
1706:
1702:
1657:
1653:
1640:
1631:
1592:
1585:
1553:
1549:
1518:
1514:
1469:
1465:
1456:
1454:
1433:
1429:
1420:
1418:
1373:
1369:
1360:
1358:
1329:
1325:
1280:
1276:
1245:
1241:
1194:
1190:
1181:
1179:
1164:
1160:
1151:
1147:
1139:Kasper et al.,
1138:
1134:
1124:
1122:
1109:
1108:
1101:
1086:
1079:
1030:
1023:
1013:
1011:
998:
997:
982:
972:
970:
957:
956:
943:
933:
931:
918:
917:
886:
882:
865:(tennis player)
847:Arthur Kornberg
838:
833:
794:
785:
776:
771:
759:
717:Viral hepatitis
661:
622:
577:
562:
546:
533:promoter region
506:glucuronidation
491:
478:Glucuronic acid
474:glucuronidation
459:
427:
419:atherosclerotic
405:
401:
397:
393:
353:
318:
302:G6PD deficiency
278:
273:
218:genetic variant
106:
98:
68:
64:
24:
21:
12:
11:
5:
3360:
3350:
3349:
3344:
3339:
3334:
3329:
3312:
3311:
3308:
3307:
3296:
3285:
3273:
3272:
3270:
3266:
3265:
3262:
3261:
3250:
3239:
3228:
3217:
3202:
3186:
3181:
3180:
3178:
3177:Classification
3168:
3167:
3164:
3163:
3161:
3160:
3158:Rotor syndrome
3155:
3149:
3147:
3139:
3138:
3136:
3135:
3130:
3125:
3119:
3117:
3106:
3094:
3093:
3090:
3089:
3087:
3086:
3081:
3076:
3071:
3065:
3063:
3055:
3054:
3052:
3051:
3042:
3036:
3034:
3026:
3025:
3023:
3022:
3017:
3015:ALAD porphyria
3011:
3009:
2998:
2990:erythropoietic
2977:
2976:
2968:
2967:
2960:
2953:
2945:
2939:
2938:
2922:
2909:
2902:
2901:External links
2899:
2897:
2896:
2856:
2847:New York Times
2833:
2816:
2809:
2781:
2732:
2715:
2664:
2641:
2589:
2538:
2501:
2472:(8): 581â587.
2452:
2423:(5): 335â340.
2403:
2360:
2339:(18): 1171â5.
2316:
2297:(3): 348â351.
2280:
2262:
2233:
2201:
2172:
2169:on 2013-04-14.
2141:(7): 2259â62.
2121:
2078:
2035:
2016:(5): 485â490.
1997:
1976:
1933:
1892:
1854:
1804:
1777:(5): 568â571.
1758:
1700:
1671:(2): 129â139.
1651:
1629:
1583:
1547:
1512:
1463:
1441:. StatPearls.
1427:
1367:
1323:
1274:
1239:
1188:
1158:
1145:
1132:
1099:
1077:
1040:(2): 193â205.
1021:
980:
941:
883:
881:
878:
877:
876:
866:
860:
850:
844:
837:
834:
832:
829:
828:
827:
824:
821:
818:
815:
812:
793:
790:
784:
781:
775:
774:Vitamin levels
772:
770:
767:
758:
755:
754:
753:
738:
720:
714:
704:Rotor syndrome
697:
687:
681:
660:
657:
621:
618:
575:
560:
544:
519:More than 100
490:
487:
458:
455:
426:
423:
403:
399:
395:
391:
352:
349:
328:'s ability to
317:
314:
277:
274:
272:
269:
249:liver problems
190:
189:
186:
182:
181:
178:
174:
173:
167:Rotor syndrome
160:
154:
153:
148:
144:
143:
140:
134:
133:
126:
120:
119:
114:
108:
107:
105:
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61:
59:
55:
54:
48:
47:
39:
38:
35:
31:
30:
22:
9:
6:
4:
3:
2:
3359:
3348:
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3338:
3335:
3333:
3330:
3328:
3325:
3324:
3322:
3306:
3302:
3301:
3297:
3295:
3291:
3290:
3286:
3284:
3280:
3279:
3275:
3274:
3271:
3267:
3260:
3256:
3255:
3251:
3249:
3245:
3244:
3240:
3238:
3234:
3233:
3229:
3227:
3223:
3222:
3218:
3216:
3212:
3211:
3207:
3203:
3201:
3197:
3196:
3192:
3188:
3187:
3184:
3179:
3175:
3159:
3156:
3154:
3151:
3150:
3148:
3145:
3140:
3134:
3131:
3129:
3126:
3124:
3121:
3120:
3118:
3115:
3114:unconjugated:
3110:
3107:
3104:
3099:
3095:
3085:
3082:
3080:
3077:
3075:
3072:
3070:
3067:
3066:
3064:
3061:
3056:
3050:
3046:
3043:
3041:
3038:
3037:
3035:
3032:
3027:
3021:
3018:
3016:
3013:
3012:
3010:
3007:
3002:
2999:
2996:
2991:
2987:
2982:
2978:
2973:
2966:
2961:
2959:
2954:
2952:
2947:
2946:
2943:
2936:
2933:
2929:
2926:
2923:
2921:
2920:Rare Diseases
2918:'s Office of
2917:
2913:
2910:
2908:
2905:
2904:
2893:
2882:
2878:
2874:
2872:
2867:
2860:
2852:
2848:
2844:
2837:
2829:
2828:
2820:
2812:
2806:
2802:
2798:
2797:
2792:
2785:
2777:
2773:
2769:
2765:
2760:
2755:
2751:
2747:
2743:
2736:
2730:
2729:Who Named It?
2726:
2725:
2719:
2711:
2707:
2702:
2697:
2692:
2687:
2683:
2679:
2675:
2668:
2660:
2656:
2652:
2645:
2637:
2633:
2629:
2625:
2620:
2615:
2611:
2607:
2603:
2596:
2594:
2585:
2581:
2576:
2571:
2566:
2561:
2557:
2553:
2549:
2542:
2526:
2522:
2518:
2514:
2513:
2505:
2497:
2493:
2488:
2483:
2479:
2475:
2471:
2467:
2463:
2456:
2448:
2444:
2439:
2434:
2430:
2426:
2422:
2418:
2414:
2407:
2399:
2395:
2391:
2387:
2383:
2379:
2375:
2371:
2364:
2356:
2352:
2347:
2342:
2338:
2334:
2330:
2323:
2321:
2312:
2308:
2304:
2300:
2296:
2292:
2284:
2276:
2272:
2266:
2251:
2247:
2243:
2237:
2222:
2218:
2214:
2208:
2206:
2190:
2186:
2182:
2176:
2168:
2164:
2160:
2156:
2152:
2148:
2144:
2140:
2136:
2132:
2125:
2117:
2113:
2109:
2105:
2101:
2097:
2093:
2089:
2082:
2074:
2070:
2066:
2062:
2058:
2054:
2050:
2046:
2039:
2031:
2027:
2023:
2019:
2015:
2011:
2004:
2002:
1995:
1991:
1988:
1983:
1981:
1972:
1968:
1964:
1960:
1956:
1952:
1948:
1944:
1937:
1929:
1925:
1920:
1915:
1911:
1907:
1903:
1896:
1888:
1884:
1880:
1876:
1873:(2): 449â56.
1872:
1868:
1861:
1859:
1843:
1839:
1835:
1831:
1827:
1823:
1819:
1815:
1808:
1800:
1796:
1792:
1788:
1784:
1780:
1776:
1772:
1765:
1763:
1747:
1743:
1739:
1735:
1731:
1727:
1723:
1719:
1715:
1711:
1704:
1696:
1692:
1688:
1684:
1679:
1674:
1670:
1666:
1662:
1655:
1649:
1645:
1644:
1638:
1636:
1634:
1625:
1621:
1617:
1613:
1609:
1605:
1601:
1597:
1590:
1588:
1579:
1575:
1571:
1567:
1564:(9): 1521â7.
1563:
1559:
1551:
1543:
1539:
1535:
1531:
1527:
1523:
1516:
1508:
1504:
1499:
1494:
1490:
1486:
1483:(4): 678â82.
1482:
1478:
1474:
1467:
1452:
1448:
1444:
1440:
1439:
1431:
1416:
1412:
1408:
1403:
1398:
1394:
1390:
1386:
1382:
1378:
1371:
1356:
1351:
1346:
1342:
1338:
1334:
1327:
1319:
1315:
1311:
1307:
1302:
1297:
1293:
1289:
1285:
1278:
1270:
1266:
1262:
1258:
1255:(4): 656â60.
1254:
1250:
1243:
1235:
1231:
1226:
1221:
1216:
1211:
1207:
1203:
1199:
1192:
1177:
1173:
1169:
1162:
1155:
1152:Boon et al.,
1149:
1142:
1136:
1120:
1116:
1112:
1106:
1104:
1095:
1091:
1084:
1082:
1073:
1069:
1065:
1061:
1056:
1051:
1047:
1043:
1039:
1035:
1028:
1026:
1009:
1005:
1001:
995:
993:
991:
989:
987:
985:
968:
964:
960:
954:
952:
950:
948:
946:
929:
925:
921:
915:
913:
911:
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