Introduction. Biliary calculosis is rare in children. It occurs associated
with different haemolytic and non-haemolytic disorders, which are sometimes
also combined. Case Outline. A 15-year-old male was hospitalized due to
biliary calculosis and non-conjugated hyper-bilirubinemia. A mild
non-conjugated hyperbilirubinemia, without anaemia and other symptoms of
liver dysfunction, was registered at age 8 years, and 7 years later
cholelithiasis with transitory choledocholithiasis. The finding of
ellyptocytes in blood smear, which was also verified in mother, normal
haemoglobin count and the absence of diseases followed by secondary
dysmorphic erythrocytes of this type, indicated a clinically milder
(compensated) hereditary ellyptocytosis, while more than a double increase of
non-conjugated serum bilirubin fracture after a three-day hypocaloric diet
(400 kcal per day) showed the concurrent presence of Gilbert?s syndrome. In
the laparascopically removed gallbladder a larger number of small pigmented
calculi were disclosed. Conclusion. Gilbert?s syndrome is an essential
precipitating factor of biliary calculosis in patients with chronic
haemolytic condition. Thus, in all cases of biliary calculosis and
non-conjugated hyperbilirubinemia with absent clinical and laboratory
parameters of liver disorders and anaemia, except in compensated haemolytic
disease and Gilbert?s syndrome as isolated disorders, a possibility of their
association should be taken into consideration.
Association of hereditary elliptocytosis and Gilbert’s syndrome as the cause of biliary calculosis: Case report