De Silva AP, Nuwanshika N, Niriella MA, de Silva HJ. Gilbert’s syndrome: The good, the bad and the ugly. World J Hepatol 2025; 17(2): 98503 [DOI: 10.4254/wjh.v17.i2.98503]
Corresponding Author of This Article
Arjuna Priyadarsin De Silva, MD, Department of Medicine, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka. apdsilva@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Feb 27, 2025; 17(2): 98503 Published online Feb 27, 2025. doi: 10.4254/wjh.v17.i2.98503
Gilbert’s syndrome: The good, the bad and the ugly
Arjuna Priyadarsin De Silva, Nilushi Nuwanshika, Madunil Anuk Niriella, Hithanadura Janaka de Silva
Arjuna Priyadarsin De Silva, Nilushi Nuwanshika, Madunil Anuk Niriella, Hithanadura Janaka de Silva, Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama 11010, Sri Lanka
Co-corresponding authors: Arjuna Priyadarsin De Silva and Nilushi Nuwanshika.
Author contributions: De Silva AP and Nuwanshika N wrote the original draft, they contributed equally as co-corresponding authors; Niriella MA and de Silva HJ investigated and reviewed the manuscript; and all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arjuna Priyadarsin De Silva, MD, Department of Medicine, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Sri Lanka. apdsilva@yahoo.com
Received: June 27, 2024 Revised: November 14, 2024 Accepted: December 20, 2024 Published online: February 27, 2025 Processing time: 237 Days and 14.6 Hours
Abstract
Gilbert’s syndrome (GS) is a common hereditary condition characterized by mild increases in serum bilirubin levels due to inherited defects in bilirubin metabolism. This review, based on peer-reviewed articles spanning from 1977 to January 2024 and sourced through the PubMed platform, provides an overview of current knowledge regarding GS. Early studies primarily focused on defining the clinical and genetic characteristics of the syndrome. More recent research has delved into the genetic mechanisms underlying the reduced expression of bilirubin UDP-glucuronosyltransferase, significantly enhancing our understanding of the pathogenesis of GS. Recent studies have also investigated clinical implications of GS, including its association with metabolic associated steatotic liver disease, cardiovascular disease, mental health and mortality risk, highlighting the complex interplay between genetic factors, bilirubin metabolism, and clinical outcomes.
Core Tip: Gilbert’s syndrome is a benign hereditary disorder characterized by mild hyperbilirubinemia. This comprehensive review delves into the genetic and environmental determinants of Gilbert’s syndrome, elucidating its possible protective role against cardiovascular diseases, metabolic disorders, and certain malignancies, attributed to the antioxidant properties of bilirubin. Additionally, it addresses potential complications during pregnancy and the neonatal period, alongside a possible association with severe schizophrenia. Emphasis is placed on the importance of early diagnosis and patient education to mitigate unnecessary medical interventions and optimize clinical outcomes.
