Which syndrome involves the liver not properly processing bilirubin, resulting in elevated serum levels?

The condition characterized by impaired bilirubin processing leading to elevated serum bilirubin levels is Gilbert syndrome. This genetic disorder is associated with a deficiency in the enzyme responsible for conjugating bilirubin in the liver, specifically uridine diphosphate-glucuronosyltransferase (UGT1A1). This results in an accumulation of unconjugated bilirubin in the bloodstream, often leading to mild jaundice, particularly during times of stress, fasting, or illness.

The other syndromes listed, while also related to bilirubin metabolism, are distinct in their mechanisms or severity. For instance, Dubin-Johnson syndrome is caused by a defect in the transport mechanism responsible for excreting conjugated bilirubin, leading to conjugated hyperbilirubinemia. Crigler-Najjar syndrome involves a more severe deficiency of the same enzyme as Gilbert syndrome and can lead to high levels of unconjugated bilirubin that pose serious health risks, particularly in its type I variant. Wilson's disease, on the other hand, involves copper accumulation in the liver and other organs and is not directly related to bilirubin processing.

Thus, Gilbert syndrome stands out as the condition where improperly processed bilirubin results specifically in elevated serum levels without the