Citation Information :
Sharma HK, Prashar S. Gilbert\'s Syndrome after Ritualistic Prolonged Fasting of Chhath Puja in Bihar, India: A Case Report and Literature Review. Indian J Med Biochem 2019; 23 (3):354-356.
Gilbert\' syndrome (GS), most common hereditary cause of unconjugated hyperbilirubinemia due to polymorphisms in uridine diphosphate glucuronosyltransferase (UGT) enzyme, was first described by Augustin Nicolas Gilbert and Pierre Lereboullet in 1901. It becomes apparent around adolescence and often precipitated by prolonged fasting, intercurrent illness, or strenuous exercise. Gilbert\'s syndrome has an excellent prognosis and does not require any treatment. But recent studies have shown that patients with GS are more susceptible to enhanced toxicity of several drugs using UGT enzyme in their metabolism. Also, hyperbilirubinemia is protective due to its anti-inflammatory, anti-oxidant, and anti-cancer properties, particularly in colon cancer. In India, followers of different religious practice a ritualistic prolonged fastings, which can predispose susceptible cases of GS to unconjugated hyperbilirubinemia. We report a rare case of GS unmasked by ritualistic prolonged fasting of Chhath Puja in Bihar to increase awareness about it among medical fraternity and patients.
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