Anestesia em paciente com síndrome de Gilbert: relato de caso

Barbosa, Fabiano Timbó; Santos, Silvio Marcos Lima dos; Costa, Joaquim Sávio Menezes Batista da; Bernardo, Ronaldson Correia

doi:10.1590/s0034-70942004000300012

Cited by 4 publications

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“…A positive history of parental consanguinity was found in the patients suffering of both conditions. Taken together, GS should be considered in per-operative evaluations in patients considered for elective surgeries to tailor the type of anesthesia, post-operative analgesics and minimize the duration of fasting in GS subjects exposed to surgery to avoid exacerbation of postoperative hyperbilirubinemia [41, 42].…”

Section: Discussionmentioning

confidence: 99%

The frequency, clinical course, and health related quality of life in adults with Gilbert’s syndrome: a longitudinal study

et al. 2019

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BackgroundGilbert syndrome (GS) is an autosomal recessive inherited disorder of bilirubin glucuronidation which has not been investigated in Egypt. This longitudinal study investigated the frequency, clinical course, genetic profile and health related quality of life in Egyptian adults.MethodsAn initial cross-sectional study was conducted to assess the frequency of Gilbert syndrome among Egyptian adults. Subjects fulfilling the criteria of GS were enrolled into the study and prospectively followed for the clinical features, risk factors for hyperbilirubinemia, health related quality of life [Short form-36 Health Survey version 2 (SF-36v2) and Chronic Liver Disease Questionnaire (CLDQ)], vitamins assessment and UGT1A1 polymorphisms.ResultsOne hundred and one subjects fulfilled the criteria of GS with a prevalence of 8.016%. Recurrent jaundice was the only presentation in 47 (56.627%) GS subjects and jaundice was associated with abdominal pain, dyspepsia or loss of appetite in 54 (53.465%) subjects. A significant difference in 25-Hydroxyvitamin D3 levels was detected between GS patients and control subjects (P < 00001). Twelve subjects with GS developed significant unconjugated bilirubinemia during direct antiviral therapy (DAAs) therapy for HCV despite achieving sustained virologic response. Pregnancy was associated with significant exacerbation of unconjugated bilirubin which persisted through pregnancy. Risk factors for clinical jaundice included general anesthesia, pregnancy, fasting > 12 h, pregnancy, and low calorie weight losing plans, systemic infections, and intensive physical effort. During jaundice attacks, subjects with GS had significant differences in vitality, role emotional, social functioning, worry and general health domains of the SF-36v2 and CLDQ compared to controls. The homozygous polymorphism A(TA)7TAA was the most frequent polymorphism in Egyptians with GS.ConclusionGilbert syndrome is a frequent inherited disorder in Egypt. In a substantial percentage of subjects with GS, episodes of jaundice are associated with other symptoms and nutritional deficiencies which result in impairment of HRQOL. Screening, counseling, monitoring and individualized health care are recommended for subjects with GS in the setting of anesthesia, pregnancy, treatment with DAAs, deliveries, surgery and weight loss plans.

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Section: Discussionmentioning

confidence: 99%

The frequency, clinical course, and health related quality of life in adults with Gilbert’s syndrome: a longitudinal study

et al. 2019

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“…Isoflurane was considered safer (<0.2% metabolized by liver)[16] as it preserves the liver blood flow. Diclofenac sodium and pentazocine were used for postoperative analgesia.…”

Section: Discussionmentioning

confidence: 99%

General anesthesia in a patient with Gilbert′s syndrome

Nag¹,

Sinha²,

Samaddar³

et al. 2011

J Anaesthesiol Clin Pharmacol

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Gilbert's syndrome, caused by relative deficiency of glucuronyl transferase is the commonest cause of congenital hyperbilirubinemia. We report anesthetic management in a case of Gilbert's syndrome for laparoscopic cholecystectomy under general anesthesia. Avoiding drugs which use this enzyme for its metabolisim or excretion, and minimizing the stress during the perioperative period allows safe conduct of anesthesia for these patients.

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“…A Síndrome de Gilbert (SG) é uma condição autossômica recessiva caracterizada por uma forma leve de hiperbilirrubinemia não conjugada (>1 mg/dL) 1,2 que afeta de 3 a 10% da população em geral 3 . Em seu aspecto típico, a hiperbilirrubinemia é notada como icterícia leve intermitente pela ligeira elevação sérica da bilirrubina não conjugada (BNC), geralmente acima de 2,5 a 3 mg/dL, podendo ser exacerbada por esforço físico pesado, jejum, privação de sono, álcool, desidratação, cirurgia e doenças concomitantes 4,5 .…”

Section: Introductionunclassified

Síndrome De Gilbert E Sua Relação Com Doenças Cardiovasculares

Silva

Murilo

et al. 2021

Rev Pat Tocantins

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RESUMO Introdução: A Síndrome de Gilbert (SG), caracterizada pelo aumento moderado de bilirrubina não conjugada (BNC), pode coexistir com outras condições mais clinicamente significativas e interferir em seus parâmetros clínicos e diagnósticos. Objetivo: Identificar na literatura a relação da Síndrome de Gilbert com doenças cardiovasculares (DCV), além de trazer uma visão geral sobre a associação da bilirrubina ao metabolismo lipídico alterado e a outros parâmetros hematológicos. Método: Trata-se de uma revisão integrativa, utilizando como fontes de pesquisa a SciELO, LILACS, PubMed e periódicos da CAPES. Artigos de revisão, relatos de casos, teses, dissertações e monografias foram excluídos. Os descritores “Doença de Gilbert”, “doenças cardiovasculares”, “hiperbilirrubinemia” e “testes hematológicos” foram utilizados no idioma inglês e seus correspondentes em português, empregando o operador booleano “AND”. Resultados: A busca nas bases de dados resultou na seleção de 11 artigos, publicados entre 2011 e 2017, que permitiram especular evidências sobre a relação existente entre a hiperbilirrubinemia leve na SG com as DCV. Níveis de estresse oxidativo reduzido, atenuação de ativação plaquetária e de processos pró-inflamatórios, hipocolesterolemia e outros achados foram associados à concentração de BNC. Conclusão: Os estudos evidenciaram possíveis mecanismos que podem contribuir para a redução do risco de DCV em indivíduos com SG, principalmente na incidência de arritmias cardíacas, doença arterial coronariana e cardiopatias ateroscleróticas. Palavras-chave: Doença de Gilbert; UDP-glucuronosiltransferase; Hiperbilirrubinemia; Doenças Cardiovasculares; Testes Hematológicos. ABSTRACT Introduction: Gilbert's Syndrome (GS), characterized by a moderate increase in unconjugated bilirubin (UCB), can coexist with other more clinically significant conditions and interfere with its clinical and diagnostic parameters. Objective: To identify in the literature the relationship between Gilbert's Syndrome and cardiovascular diseases (CVD), in addition to providing an overview of the association of bilirubin with altered lipid metabolism and other hematological parameters. Method: This is an integrative review, using SciELO, LILACS, PubMed and CAPES journals as research sources. Review articles, case reports, theses, dissertations and monographs were excluded. The descriptors "Gilbert Disease", "cardiovascular diseases", "hyperbilirubinemia" and "hematologic tests" were used in english and their correspondents in portuguese, using the boolean operator "AND". Results: The search in the databases resulted in the selection of 11 articles, published between 2011 and 2017, which allowed speculating evidence on the relationship between mild hyperbilirubinemia in GS and CVD. Levels of reduced oxidative stress, attenuation of platelet activation and pro-inflammatory processes, hypocholesterolemia and other findings were associated with UCB concentration. Conclusion: The studies showed possible mechanisms that can contribute to the reduction of CVD risk in individuals with GS, mainly in the incidence of cardiac arrhythmias, coronary artery disease and atherosclerotic heart diseases. Keywords: Gilbert Disease; UDP-glucuronosyltransferase; Hyperbilirubinemia; Cardiovascular Diseases; Hematologic Tests

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Anestesia em paciente com síndrome de Gilbert: relato de caso

Abstract: Gilbert's syndrome patients may be safely submitted to general anesthesia without toxicity, provided factors leading to glucuronosyltransferase activity decrease are avoided.

Cited by 4 publications

References 1 publication

The frequency, clinical course, and health related quality of life in adults with Gilbert’s syndrome: a longitudinal study

The frequency, clinical course, and health related quality of life in adults with Gilbert’s syndrome: a longitudinal study

General anesthesia in a patient with Gilbert′s syndrome

Síndrome De Gilbert E Sua Relação Com Doenças Cardiovasculares

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