Inspissated Bile Syndrome Secondary to G6DP Deficiency in A Tertiary Care Hospital

¹Assistant Professor, Department of Pediatrics, Dr. Ziauddin Hospital, KDLB, Karachi, Pakistan

²House Officer, Dr. Ziauddin Hospital, North Nazimabad Karachi, Pakistan

³House Officer, Dr. Ziauddin Hospital, North Nazimabad Karachi, Pakistan

⁵Peadiatrics Resident, Dr. Ziauddin Hospital, KDLB, Karachi, Pakistan

*Corresponding author: Ramna Shafique, House Officer, Dr. Ziauddin Hospital, North Nazimabad Karachi, Pakistan, Tel: 03493659018, E-mail: [email protected]

Received Date: August 07, 2026
Published Date: September 05, 2026

Citation: Anwar T, et al. (2026). Inspissated Bile Syndrome Secondary to G6DP Deficiency in A Tertiary Care Hospital. Cases. 5(2):30.

Copyright: Anwar T, et al. © (2026).

ABSTRACT

Introduction: IBS is described as an obstruction of the extrahepatic duct by a bile plug, sludge without bile duct malformation, congenital bile chemical abnormalities, or hepatocellular lesions. It is a relatively rare cause of cholestatic jaundice in infancy.

Case Report: A case of a 15-day-old female brought to the outpatient department with complaints of yellowish discoloration of the skin since birth and a history of meconium staining at birth. On investigation, her hemoglobin, total, and direct bilirubin levels came out to be abnormal, with a G6PD of 0.5 mIU/Ml, abnormal total and direct bilirubin levels and positive coombs test. Ultrasound abdomen showed a partially contracted gallbladder with a CBD of 1.3 mm. Following the confirmation of G6PD deficiency, a diagnosis of inspissated bile syndrome secondary to G6PD was made. Along with her ongoing medication, oral ursodeoxycholic acid was added to her regimen. The patient was discharged on meropenem and vancomycin, on the follow-up day, ultrasonography showed a significant reduction in the CBD's diameter. The patient’s serum bilirubin levels, haemoglobin, and other biochemical levels returned to normal.

Discussion: Neonatal jaundice is a common symptom that is often caused by a physiological process. However, conjugated hyperbilirubinemia caused by physical or functional occlusion of the extrahepatic bile duct necessitates immediate diagnostic evaluation and therapy. A 15-day-old female weighing 2.9 kg, born at term to a 28-year-old multiparous female with a history of meconium staining at birth, was brought to the outpatient department with complaints of yellowish discoloration of the skin for 2 weeks. Upon investigation, inspissated bile syndrome secondary to G6DP deficiency was diagnosed, was treated conservatively, and got positive results.

Conclusion: IBS secondary to HDN accounts for 8% of all types of surgical jaundice during infancy. In some cases, ursodeoxycholic acid (UDCA) appears to be a safe and effective treatment for IBS. However, the possibility of omega-3 PUFAs as a choleretic agent for IBS can also be used as an alternative to surgical intervention. Adjuvant serum changes before, during, and after therapy for IBS could provide additional visual information about the intensity of hemolysis and the efficacy of UDCA. Moreover, prompt diagnosis and use of basic to advanced imaging modalities and investigations are important for early detection and decreasing complications.

Keywords: Meconium Stanning, Coombs Test, Ursodeoxycholic Acid