GILBERT’S SYNDROME- A CASE WITH INTERPRETATION AND MANAGEMENT IN UNANI MEDICINEAbstract
Background: Gilbert’s syndrome (GS) is the most common form of congenital, non haemolytic, mild unconjugated hyperbilirubinaemia. Familial cases linked with mutation in enzyme UDP glucuronosyl transferase 1 producing decreased conjugation of bilirubin which accumulates in the form of unconjugated bilirubin. Hyperbilirubinaemia is mild (<6 mg/dl) while liver enzymes & histology are always found normal. It is clinically characterized by vague symptoms like loss of appetite, abdominal pain, weight loss and mild Jaundice. A review of Unani literature showed disease similarity clinically with Su-e-Mizaj Jigar Har Yabis, with dominating features of Safra (yellow bile). Material and Methods: We report our experience with such a case of GS by validated integrative assessment and management with Unani medicine e.g. Arqayat (Makoh+Kasni+Biranjasif), Jigreen, Sharbat-e-Bazoori and Majoon Dabid-ul-Ward along with a short review of literature. Results were analyzed based on clinical and LFT outcomes. Results: Significant symptomatic relief was achieved over 5 weeks of treatment. Bilirubin levels normalized but rose after 5 weeks. Literature review showed disease similarity with Su-e-Mizaj Har Yabis Sadaa which under the aggravating factors progressed to Su-e-Mizaj Har Safrawi. Conclusion: As single abnormal gene in the GS runs in the families & leads to reduced enzymatic expression. This decreases conjugation of unconjugated bilirubin and ultimately unconjugated hyperbilirubinaemia. Thereby normal levels of bilirubin were achieved for concise period of time with symptomatic relief which proves the effectiveness of Unani medicine in GS but establishment of the therapy needs planned study on multiple patients.
S. Ansari *, Fasihuzzaman, M. A. Siddiqui, S. Nikhat and S. Mushtaq
Department of Moalejat (Unani medicine), Faculty of Medicine (U), Jamia Hamdard, New Delhi, Delhi, India
27 December 2014
19 January 2015
27 January 2015
01 February 2015