Introduction Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 Case 3 A 27 year old man presents for routine physical examination for insurance purposes.
Examination is normal.
LFTs were as shown in Table 4. The most likely diagnosis is Gilbert's syndrome. Haemolysis can present with identical LFTs and should be excluded by clinical examination and appropriate investigations. An isolated elevated bilirubin is almost never related to hepatobiliary disease. Answer 2 Repeat LFTs after a 24 hour fast, including measurement of unconjugated bilirubin.