Double whammy leading to recurrent jaundice

Abstract

Recurrent jaundice has multiple etiologies and is often due to pre-hepatic causes. A 29-year-old male presented with recurrent jaundice of 6 years duration. He had unconjugated hyperbilirubinemia and was subjected to fasting test, which confirmed the diagnosis of Gilbert's syndrome. However, the presence of atypical features like splenomegaly, marked elevation in bilirubin and red cell distribution width prompted us to look for another etiology. Hemoglobin electrophoresis confirmed the presence of thalassemia trait thereby confirming our suspicions. We report this case for the unusual combination of Gilbert's syndrome with thalassemia minor to highlight the importance of looking beyond the obvious in clinical medicine.