old women came to you and she wanted (special water+sugar ) for her son (bacuase he jaundiced
8yrs boy start fasting his first time at ramadan , and he complain of fatigue , nausea , yellow sclera , no previous history of jaundice
spot diagnosis : gilbert syndrome
physician send him bilirubin test and was 3.9 (mainly indirect)*(normal bilirubin 0-1md/dl) and this considered high because pt with gilbert the expected range less than 3mg/dl
* you should know that hyperbilirubinemia of GS harmless and mild , and no drug treatment needed in adult
pt was referred for medicine doctor , he considered phenobarbitol as drugs management (because phenobarbital or luminal liver enzyme inducer (liver enzyme decrease indirect bilirubin)
also phenobarbital(mainly for fit ) can used to treat hyperbilirubinemia in crigler-najjar syndrome in pediatric age group
*note : phenobarbital also support diagnosis of GS in unknown cases of GS