Gilbert syndrome

Vignette says a 20 year old male presents to his primary care physician with chief complaints of yellowing of his eyes over the past few days; There is no significant past medical history; He reports that he has been under a lot of stress recently as his finals are coming near; Vital signs are stable; Examination shows scleral icterus; Laboratory studies show normal CBC, normal AST & ALT, total bilirubin of 2.4 mg/dL (normal range is 0.1-1.2 mg/dL) and direct bilirubin of 0.2 mg/dL (normal range is less than 0.3mg/dL); Direct coombs test is negative; Diagnosis?
 
Diagnosis is Gilbert syndrome.

Gilbert syndrome is the most common inherited metabolic disorder of bilirubin which results from the partial deficiency UDP glucuronosyltransferase activity.

Presents with jaundice and elevation of unconjugated bilirubin following stress (e.g. fever, fasting, dehydration, vigorous exercise, menstruation, surgery, trauma).

Diagnosis:-
1. Elevated unconjugated bilirubin (i.e. indirect hyperbilirubinemia).
2. CBC, PBS, RFT and LFT are normal.

Treatment:- Gilbert syndrome is a benign condition and does not require treatment.