An Epileptic Patient with Recurrent Hyperbilirubinemia Caused by Gilbert Syndrome

Yaoyao Zhang; Yongli Jiang; Fang Yuan; Changgeng Song; Zhihan Zhao; Wen Jiang

doi:10.1159/000504645

An Epileptic Patient with Recurrent Hyperbilirubinemia Caused by Gilbert Syndrome

Case Rep Gastroenterol. 2020 Jan 22;14(1):39-47. doi: 10.1159/000504645. eCollection 2020 Jan-Apr.

Authors

Yaoyao Zhang¹, Yongli Jiang¹, Fang Yuan¹, Changgeng Song¹, Zhihan Zhao¹, Wen Jiang¹

Affiliation

¹ Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

Abstract

Gilbert syndrome (GS) is characterized by intermittent indirect bilirubin elevation. Several antiepileptic drugs (AEDs) impair the liver function to different degrees, such as valproic acid, lamotrigine, phenobarbital, phenytoin, and carbamazepine. Herein, we present the case of a 26-year-old epileptic patient with frequently recurring mild hyperbilirubinemia during taking AEDs. After repeated adjustment of the doses and types of AEDs, the bilirubin level still remained elevated. He was then referred to the Gastroenterology Department. The results of diagnostic tests, clinical manifestation, imaging studies, liver biopsy and whole-exome sequencing all made contributions to our conclusion that GS played an important role in the elevation of bilirubin. Ultimately, his seizure was controlled by levetiracetam (500 mg per day) and he was advised to periodically undergo the liver function tests.

Keywords: Gilbert syndrome; Hyperbilirubinemia; Lamotrigine; UGT1A1; Valproic acid.

Publication types

Case Reports