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Is glucose 6 phosphate dehydrogenase deficiency is the answer for this

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"Unconjugated Hyperbilirubinemia"[MeSH Terms]

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unconjugated hyperbilirubinemia negative urine bilirubin normal liver enzymes hemolysis laboratory findings

Not specifically G6PD deficiency. The best diagnosis from the given data is hemolytic (prehepatic) jaundice with unconjugated hyperbilirubinemia, possibly associated with pigment gallstones causing the right-upper-quadrant colicky pain.
Why:
  • Total bilirubin = 5.8 mg/dL, direct bilirubin = 0.2 mg/dL: predominantly unconjugated bilirubin.
  • Indirect Van den Bergh positive: supports unconjugated hyperbilirubinemia.
  • Urine bilirubin negative: unconjugated bilirubin is albumin-bound and water-insoluble, so it cannot be filtered into urine. This is characteristic of hemolytic jaundice. Robbins explanation
  • AST, ALT, and ALP are normal: argues against hepatocellular or obstructive jaundice.
  • Chronic hemolysis increases bilirubin turnover and can form black pigment gallstones, leading to biliary colic.
G6PD deficiency can be one possible cause of hemolysis, especially if there is a history of oxidant-drug exposure, fava beans, infection, anemia, reticulocytosis, raised LDH, low haptoglobin, bite cells, or Heinz bodies. But none of these are given, so you should not write G6PD deficiency as the definite diagnosis.
For an exam answer, write:
Probable diagnosis: Hemolytic jaundice (prehepatic unconjugated hyperbilirubinemia), with pigment gallstone disease causing biliary colic.
Excess RBC breakdown produces excess unconjugated bilirubin. The liver cannot conjugate all of it, causing raised indirect bilirubin and an indirect-positive Van den Bergh reaction. Unconjugated bilirubin is insoluble in water and albumin-bound, hence urine bilirubin is negative. Liver enzymes remain normal. Increased bilirubin excretion into bile predisposes to pigment gallstones.
The dark urine is not bilirubinuria here. It may reflect increased urobilinogen or, if acute intravascular hemolysis is present, hemoglobinuria.
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