Yuan Xiao-Ye, He Xiang-Ling, Zou Hui, Zou Run-Ying
Department of Pediatric Hematology and Oncology, Hunan People's Hospital, Changsha 410005, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2017 Jan;19(1):77-80. doi: 10.7499/j.issn.1008-8830.2017.01.013.
A two-year-old girl was admitted due to repeated yellowing of the skin and sclera for 2 years and had no other specific symptoms or signs. The use of phenobarbital could relieve the symptoms of jaundice. Multiple examinations showed increased indirect bilirubin levels, and the results of aminotransferases and liver imaging were normal. There was no evidence of hemolysis. The analysis of UGT1A1 gene in her family found that this child had double homozygous mutation of c.211G>A(G71R) and c.1456T>G(Y486D), which had been reported as the pathogenic mutation for Gilbert syndrome. Her parents carried double heterozygous mutation of G71R and Y486D and had no symptom of jaundice. The child was diagnosed as having Gilbert syndrome. It is concluded that as for patients with unconjugated hyperbilirubinemia which cannot be explained by liver damage and hemolysis, their family history should be investigated in detail and gene analysis should be performed as early as possible, in order to identify congenital bilirubin metabolic disorders.
一名两岁女童因皮肤和巩膜反复黄染2年入院,无其他特异性症状或体征。使用苯巴比妥可缓解黄疸症状。多项检查显示间接胆红素水平升高,转氨酶及肝脏影像学检查结果正常。无溶血证据。对其家族进行UGT1A1基因分析发现,该患儿存在c.211G>A(G71R)和c.1456T>G(Y486D)的双纯合突变,这已被报道为吉尔伯特综合征的致病突变。其父母携带G71R和Y486D的双杂合突变,无黄疸症状。该患儿被诊断为吉尔伯特综合征。结论是,对于无法用肝损伤和溶血解释的非结合性高胆红素血症患者,应详细调查其家族史并尽早进行基因分析,以明确先天性胆红素代谢障碍。