Clinicopathologic diagnosis and characterization of Gilbert's syndrome
Objective To analyze and summarize the clinical,laboratory examination and pathological patterns of 25 cases of Gil-bert's syndrome,and to provide certain experience for clinical pathological diagnosis.Methods 25 cases of Gilbert syndrome clearly diagnosed in the Department of Pathology of the First Affiliated Hospital of Xinjiang Medical University from 2017 to 2022 were col-lected,and the clinical characteristic,laboratory examinations and pathological patterns of Gilbert syndrome were analyzed retrospec-tively.Results(1)General characteristics:16 cases were male and 9 cases were female,with ages ranging from 14 to 63 years old,and the average age was 40.1 years old.(2)Clinical manifestations:Of the 25 patients,12 cases had recurrent yellowing of the skin starting at an early age,and 6 cases had occasional malaise.(3)Laboratory tests:25 patients were negative for viral serology and auto-immune antibodies.Hemoglobin[141.56±14.27 g/L]and reticulocyte count[45.37±15.37 109/L]were normal,and anti-human globulin hemolysis test was negative.25 patients had elevated unconjugated bilirubin(IBil)[49.49±31.08 µmoL/L],alkaline phos-phatase(ALP)was elevated in one case[69.87±58.05U/L].Conjugated bilirubin(DBil)[1.60±1.70μmoL/L],mentholamine ami-notransferase(AST)[24.84±7.29 U/L],alanine aminotransferase(ALT)[26.07±7.44 U/L],and gamma-glutamyltransferase(γ-GGT)[24.32±13.41 U/L]were normal.Rifampicin test was positive in 21 patients.(4)Imaging examination:ultrasound,CT liver and spleen did not show any abnormality.(5)Liver tissue biopsy:histopathology of 25 cases showed that the basic structure of the liver lobules was still good,with fine brown particles in the cells of the three regions of the liver lobules,and no special changes in the rest.Conclusions Gilbert's syndrome is characterized by elevated unconjugated bilirubin,and pathology is characterized by the presence of fine brown granules in the cells of liver lobule zone 3,with a majority of positive rifampicin tests.The diagnosis of GS can be fulfilled if the clinical manifestations,pathologic features and laboratory tests are eligible,and genetic testing can confirm the diagnosis.
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