A 25-year-old male with no previous history of jaundice presents with yellowish discoloration of sclera for 3 days along with fatigue and abdominal pain. He has been fasting for the past 3 days due to religious reasons. On examination, abdomen was soft and tender with no evidence of hepatomegaly. Hepatic histology showed a moderate increase in the lipofuscin pigment. Which of the following would be expected in this patient?
High-Yield Explanation
A healthy male presenting with jaundice following a period of fasting raises the suspicion of Gilbe syndrome. It is the most common inherited disorder of glucuronidation characterized by decreased UDP-glucuronosyltransferase activity leading to unconjugated hyperbilirubinemia (<3 mg/dl) triggered by fasting, stress, physical exeion or a fat-free diet. Typically, liver enzymes are normal.