apfcbAPFCB eNewscoAPFCB News Volume 4, Issue 2MultidisciplinaryEnglishJul-Dec, 2025NNY20250831ArticlesUnveiling the clinical conundrum: coexistence of Gilbert’s syndrome and ThrombocytopeniaEnglishY139145Dr. ChetenyChetenyEnglishNDr. EnitarastSympliEnglishYDr. KapilKumarEnglishYDr. Chillarige SudhaAnkitaEnglishYDr. SwatiSinghEnglishY10.62772/APFCB-News.2025.4207Gilbert’s syndrome (GS) is a benign hereditary disorder of bilirubin conjugation resulting in an isolated, elevated blood level of unconjugated bilirubin. An individual with GS is typically asymptomatic and does not require treatment. Thrombocytopenia is not a known feature of GS and may suggest an alternate or co-existing pathology. We report a rare case of a 40-year-old male, with an incidental finding of mildly increased unconjugated bilirubin levels on two different occasions with moderate thrombocytopenia in the absence of any aggravating factors. Further investigations were done to rule out autoimmune, infectious or hemolytic causes. This report underscores the need to consider genetic disorders in the differential diagnosis of patients with unexplained thrombocytopenia, it also highlights the critical value of laboratory findings in avoiding misdiagnosis of GS.EnglishUnconjugated Bilirubin, Thrombocytopenia, Hyperbilirubinemia, Case report, Platelets, Incidentalhttps://apfcb.org/APFCB_News/abstract?id=44References16191. De Silva AP, Nuwanshika N, Niriella MA, de Silva HJ. Gilbertand;#39;s syndrome: The good, the bad and the ugly. World J Hepatol. 2025 Feb 27;17(2):98503. doi: 10.4254/wjh. v17.i2.98503. PMID: 40027563.2. Black M, Billing BH. Hepatic bilirubin udp-glucuronyl transferase activity in liver disease and gilbertand;#39;s syndrome. N Engl J Med. 1969 Jun 5;280(23):1266-71. doi: 10.1056/NEJM196906052802303. PMID: 5770050.3. Sticova E, Jirsa M. New insights in bilirubin metabolism and their clinical implications. World J Gastroenterol. 2013 Oct 14;19(38):6398-407. doi: 10.3748/wjg. v19.i38.6398. PMID: 241513584. mellie WS, Ryder SD. Biochemical and;quot;liver function testsand;quot;. BMJ. 2006 Sep 2;333(7566):481-3. doi: 10.1136/bmj.333.7566.481. PMID: 169463365. Vand;iacute;tek L, Jirsa M, Brodanovand;aacute; M, Kalab M, Marecek Z, Danzig V, Novotnand;yacute; L, Kotal P. Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis. 2002 Feb;160(2):449-56. doi: 10.1016/s0021-9150(01)00601-3. PMID: 11849670.6. Sarlak H, Arslan E, Cakar M, Tanriseven M, Ozenc S, Akhan M, Bulucu F. Relation between unconjugated bilirubin and RDW, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio in Gilbertand;#39;s syndrome. Springerplus. 2016 Aug 22;5(1):1392. doi: 10.1186/s40064-016-3085-5. PMID: 276103117. Cure MC, Cure E, Kirbas A, Cicek AC, Yuce S. The effects of Gilbertand;#39;s syndrome on the mean platelet volume and other hematological parameters. Blood Coagul Fibrinolysis. 2013 Jul;24(5):484-8. doi: 10.1097/MBC.0b013e32835e4230. PMID: 23348429.