Clinical Report: Misinterpretation of Gilbert Syndrome as DILI in TB Therapy
Overview
This case study discusses the misinterpretation of Gilbert syndrome as drug-induced liver injury (DILI) during tuberculosis treatment, leading to unnecessary treatment interruptions. Genetic testing confirmed Gilbert syndrome.
Background
Drug-induced liver injury (DILI) is a frequent complication of anti-tuberculosis therapy, often leading to treatment modifications. Isolated indirect hyperbilirubinemia with normal transaminase levels can indicate conditions like Gilbert syndrome, which may be overlooked in clinical practice.
Data Highlights
No numerical data or trial data is presented in the article.
Key Findings
A 22-year-old woman with pulmonary tuberculosis experienced recurrent indirect hyperbilirubinemia with normal liver enzyme levels.
Her condition was misinterpreted as DILI, leading to multiple interruptions of anti-tuberculosis therapy.
Genetic testing revealed Gilbert syndrome.
Persistent indirect hyperbilirubinemia should prompt consideration of Gilbert syndrome rather than DILI.
Clinical Implications
Clinicians should be aware that isolated indirect hyperbilirubinemia with normal transaminases may indicate Gilbert syndrome rather than DILI.
Conclusion
This case highlights the importance of considering alternative diagnoses like Gilbert syndrome in patients with atypical liver function test results during tuberculosis treatment.
More than 5,100 additional reports require further analysis as federal and state partners investigate several outbreaks and work to identify their sources.
