Idiopathic Unconjugated Hyperbilirubinemia (Gilbert's Syndrome)

IN 1901 Gilbert and Lereboullet1 described the syndrome of chronic, benign, intermittent jaundice, which was later shown to be distinct from hemolytic disease2 and to be associated with a retention of unconjugated bilirubin in the plasma. It is now known that there are many causes of unconjugated hyperbilirubinemia in addition to hemolytic disease. These include an inherited deficiency of hepatic glucuronyl transferase,3 , 4 shunt hyperbilirubinemia,5 drugs such as rifamycin6 and novobiocin,7 cholecystographic agents8 and portacaval-shunt surgery.9 It is also said to follow viral hepatitis and a wide variety of acquired diseases.4 , 10 , 11 When these conditions have been excluded, there is still the . . .