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Old 09-30-2015
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Default Q. pathophysio of apparent jaundice in Gilbert syn?

Q. Most individuals affected by Gilbert syndrome are asymptomatic but Jaundice becomes apparent only following stress, exertion, dehydration alcohol consumption, fasting, and/or infection. My question is- what is the pathophysiology by which these triggering factors cause apparent jaundice in a patient with Gilbert syndrome?Thanks.
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Old 09-30-2015
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Good question. I think when there is infection, there will be oxidative stress (neutrophils make oxygen derived radicals to kill the bacteria) -----> thus RBC will be damaged which leads to hemolysis ----> excessive unconjugated bilirubin cannot be conjugated in the liver due to deficiency of UGT enzyme in patients with Gilbert syndrome ----> unconjugated bilirubin deposits in the skin which causes the jaundice.

This is how I understand it.
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Old 10-01-2015
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Thanks Medical student 93.

Your explanation about neutrophil mediated free radical damage of RBCS due to infection makes a lot of sense.But, exertion, dehydration, alcohol consumption and fasting are not the infectious casuses . How can they cause hemolysis OR apparent jaundice? this is the point where I was especially confused.

If anybody can clear this confusion, I would be very thankful.
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Old 08-10-2016
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Quote:
Originally Posted by Aumsai View Post
Thanks Medical student 93.

Your explanation about neutrophil mediated free radical damage of RBCS due to infection makes a lot of sense.But, exertion, dehydration, alcohol consumption and fasting are not the infectious casuses . How can they cause hemolysis OR apparent jaundice? this is the point where I was especially confused.

If anybody can clear this confusion, I would be very thankful.

"exertion, dehydration, alcohol consumption and fasting" can lead to free radical production and damage...... so they have the same effect of infections on jaundice
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