A 29-year-old woman is found, on routine annual blood testing, to have a small increase in unconjugated bilirubin. There is no evidence of hemolysis and her liver enzymes and function tests are otherwise normal. She has no prior history of liver disease and is not taking any medications. Her physical examination is completely normal with no signs of chronic liver disease. Which of the following is the most likely diagnosis?
Gilbert syndrome may be associated with impaired hepatic uptake of bilirubin. It is caused by hereditary decrease in the activity of glucuronosyltransferase in the uridine diphosphate glycosyltransferase 1 (UGT1) family. More severe enzyme deficits are the cause of the two variants of Crigler-Najjar syndrome and usually present in the neonatal period with very high elevations in unconjugated bilirubin, making it not the correct answer in this patient. She does not have Dubin-Johnson or Rotor syndrome since both of these entities have elevations of conjugated bilirubin.
Crigler-Najjar syndrome
Dubin-Johnson syndrome
Rotor syndrome
Gilbert syndrome
G.I.T.