Jaundice with hypertrophic pyloric stenosis: a possible early manifestation of Gilbert syndrome

Jaundice with hypertrophic pyloric stenosis as an early manifestation of Gilbert syndrome

Jaundice associated with hypertrophic pyloric stenosis was recognised in three patients; previous reports have suggested that this is a possible early manifestation of Gilbert syndrome. Most patients with Gilbert syndrome are homozygous for a (TA)(7)TAA polymorphism in the gene promoter coding for bilirubin glucuronosyltransferase. Two of the reported patients were homozygous for the (TA)(7)TAA polymorphism whereas the third was heterozygous for the same polymorphism. Furthermore, no other factors contributing to jaundice in the three patients were found. These results suggest that jaundice associated with hypertrophic pyloric stenosis is due to molecular defects within the gene promoter.

Gilbert syndrome

Two or three times a year, a healthy patient (> 1 year old) with mild unconjugated hyperbilirubinemia as the only abnormality on routine liver function testing will be referred to the gastroenterologist. A diagnosis of Gilbert Syndrome (GS) is made, and the patient may or may not be seen in the clinic or office because GS is a benign condition. Either way, the nurse needs to understand the pathophysiology of this condition so he/she can provide necessary patient/family education. The purpose of this article is to review the existing literature on GS and to summarize it in a manner useful to both nurses and families.