Unconjugated hyperbilirubinemia is seen in -
Ans. is 'c' i.e., Gilbert syndrome {Ref: Harrison 18th/e p. 325 fig (42.1), 326 table (42.1); 17th/ep. 263 t. (43.1)]Causes of isolated hyperbilirubinemiaIsolated Indirect hyperbilirubinemiaIsolated Direct hyperbilirubinemiaA) Inherited conditionsInherited conditionso Cirgler Najjar type I and IIo Dubin Jhonson syndromeo Gilbert's syndromeo Rotors syndromeB) Ineffective ervthropoiesis Cobalamine folate, thalassemia, and severe iron deficiencies C) Drugs Rifampicin, Probenecid, Ribavarin D) Hemolytic disorder 1) Inherited o Spherocytosis, Elliptocytosis Glucose 6 phosphate dehydrogenase Pyruvate kinase deficiency o Sickle cell anemia 2) Acquired o Microangiopathic hemolytic anemia o Paroxysmal nocturnal hemoglobinuria o Immune hemolysis Unconiugated Bilirubin (Indirect bilirubin)o Isolated elevation o f unconjugated Bilirubin is rarely due to liver disease.o An isloated elevation of unconjugated Bilirubin is seen primarily in hemolytic disorders and in number of genetic conditions such as Crigter Najar and Gilbert's syndrome.Conjugated Bilirubin (Direct bilirubin)o In contrast to unconjugated bilinibinemia, conjugated bilirubinemia almost always implies liver or biliary tract disease.o Elevation of conjugated bilirubin may be seen in any type of liver disease. In most of the liver diseases both conjugated and unconjugated fraction of the bilirubin may be elevated.
Rotor syndrome
Dubin-Johnson syndrome
Gilbert syndrome
Bile duct obstruction
Liver