Question 232 · LEK · Gilbert syndrome
A 19-year-old man comes to the office because of yellowish whites of his eyes. Serum bilirubin concentration was 2.9 mg/dL (50 µmol/L). Following tests were normal: abdominal ultrasound, blood count, urine test, LDH, ALT, AST, GGT, ALP, HBS antigen and anti-HCV antibodies. The patient complains of stress associated with his oncoming secondary school-leaving examination. What should be the next step in diagnosis and treatment?
- A. liver biopsy.
- B. abdominal computer tomography scan.
- C. abdominal magnetic resonance imaging.
- D. endoscopic retrograde cholangiopancreatography.
- E. only healthy lifestyle should be recommended without any further diagnostics.
Hint
Isolated hyperbilirubinemia with normal haemolysis markers, liver enzymes and imaging, provoked by stress, points to a benign condition.
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