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Dubin-Johnson syndrome

最后审阅: 24 Sep 2025
最后更新: 10 Dec 2024

小结

定义

病史和体格检查

关键诊断因素

  • intermittent jaundice
  • lack of pruritus
完整详情

其他诊断因素

  • illness, infection, or stress
  • pregnancy-triggered jaundice
  • medication-triggered jaundice
  • abdominal pain
  • fatigue
  • hepatomegaly
完整详情

危险因素

  • family history
  • age 10 to 30 years
  • Iranian Jewish or Moroccan Jewish ethnicity
  • male sex
完整详情

诊断性检查

首要检查

  • serum bilirubin
  • serum alkaline phosphatase
  • serum liver aminotransferases (aspartate aminotransferase and alanine aminotransferase)
  • serum albumin
  • serum gamma-glutamyl transferase
  • serum bile acids
  • clotting profile
完整详情

需考虑的检查

  • urinary coproporphyrin I to III ratio
  • 99mTc hepatobiliary imino-diacetic acid (HIDA) scan (cholescintigraphy)
  • liver biopsy
  • mutational analysis of the ABCC2 gene
完整详情

新兴检查

  • urinary leukotriene metabolites

治疗流程

急症处理

all patients

撰稿人

作者

Anil Dhawan, MBBS, MD, FRCPCH
Anil Dhawan

Professor of Paediatric Hepatology

King's College Hospital

London

UK

利益声明

AD declares he has no competing interests.

Tracy A.F. Coelho, MBBS, DCH, MRCPCH, PhD
Tracy A.F. Coelho

Consultant Paediatric Gastroenterologist

University Hospital Southampton

Southampton

UK

利益声明

TAFC declares that he has no competing interests.

同行评议者

John T. Jenkins, MB, CHB, FRCP

Consultant Surgeon

St. Mark's Hospital

London

UK

利益声明

JTJ declares that he has no competing interests.

Nancy Reau, MD

Assistant Professor of Medicine

University of Chicago

Center for Liver Disease

Chicago

IL

利益声明

NR has received reimbursement for speaking for Gilead, maker of Viread and Hepsera, and BMS, maker of Baraclude.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Dubin IN, Johnson FB. Chronic idiopathic jaundice with unidentified pigment in the liver cells: a new clinicopathologic entity with report of 12 cases. Medicine. 1954 Sep;33(3):155-97. 摘要

Dubin IN. Chronic idiopathic jaundice: a review of 50 cases. Am J Med. 1958 Feb;24(2):268-92. 摘要

Kwo PY, Cohen SM, Lim JK. ACG clinical guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol. 2017 Jan;112(1):18-35. 摘要

Machida I, Wakusawa S, Sanae F, et al. Mutational analysis of the MRP2 gene and long-term follow-up of Dubin-Johnson syndrome in Japan. J Gastroenterol. 2005 Apr;40(4):366-70. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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