Case Report: Persistent indirect hyperbilirubinemia caused by Gilbert syndrome misdiagnosed as drug-induced liver injury during tuberculosis treatment - Takeaways - MDSpire

Case Report: Persistent indirect hyperbilirubinemia caused by Gilbert syndrome misdiagnosed as drug-induced liver injury during tuberculosis treatment

  • By

  • Ping Liu

  • Yuming Xu

  • July 16, 2026

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  • 1

    A 22-year-old woman with pulmonary tuberculosis developed recurrent indirect hyperbilirubinemia while transaminase levels remained normal.

  • 2

    Misinterpretation of her bilirubin elevations as drug-induced liver injury led to multiple interruptions of her anti-tuberculosis therapy.

  • 3

    Genetic testing confirmed the diagnosis of Gilbert syndrome, an inherited disorder causing intermittent unconjugated hyperbilirubinemia.

  • 4

    The patient's treatment delays exceeded one year, resulting in disease progression and complications such as cavity formation.

  • 5

    This case emphasizes the need to consider Gilbert syndrome in tuberculosis patients with isolated indirect hyperbilirubinemia and normal transaminases.

Original Source(s)

Case Report: Persistent indirect hyperbilirubinemia caused by Gilbert syndrome misdiagnosed as drug-induced liver injury during tuberculosis treatment

  • by Ping Liu, Yuming Xu

  • July 16, 2026

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