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KMID : 0376219650020020239
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Chonnam Medical Journal
1965 Volume.2 No. 2 p.239 ~ p.242
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Congenital Nonhemolytic Jaundice with Unconjugated Bilirubin in the Serum
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Abstract
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Gilbert et al described a case with elevation of the indirect acting serum bilirubin in 1907, and since then there have been numerous reviews of this syndrome published under a variety of names. However, the reports of nonhemolytic and nonobstructive hyperbilirubinemia are lacking in this country.
Recently at the department of Internal Medicine, Chonnam University Medical School a case of congenital nonhemolytic jaundice with unconjugated bilirubin in´the serom was observed.She was a 20 years old unmarried . female with complaints of jaundice. There was nopast history suggestive of hepatitis, biliary tract diseaise or hematrfogic disorder. she stated that she had taken an adequate diet and had consumed no alcoholic beverages. Repeated physical examinations had been negative except for the icteric sclerae. Hematologic studies showed no abnomalities in cell morphology or hemoglobin, and there was no evidence of excessive hemolysis. Urinalysis showed normal total protein (6.9gm% with 3.45gm albumin). The alkaline phosphatase was 4.8 K-A units; SGOT 15 units; SGPT 12 units; prothrombin time 14 seconds with control of 12 seconds;thymol turbidity 6.42 units. The sulfobro-mophthalein test showed 6.4% dye retention in 45 minites. The cephaline flocculation was 2+ at the end of 48 hours. The quantitative determination of bilirubin was 5.59mg% with 0.74mg% direct actiong. The chest X-ray and upper gastrointestinal series were normal. An oral cholecystogram with telepaque showed normal visualization of gall bladder. The eletrocardiogram was within normal limits. Needle biopsy of the liver was not performed due to the patient was hospitalized for 11 days, and, as noted, her jaundice was not changed. Thus she is considered to be a case of Gilbert´s disease. Review of current literatures was described.
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