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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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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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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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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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