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Dubin-Johnson syndrome

Last reviewed: 5 Oct 2024
Last updated: 24 Aug 2023

Summary

Definition

History and exam

Key diagnostic factors

  • intermittent jaundice
  • lack of pruritus
Full details

Other diagnostic factors

  • illness, infection, or stress
  • pregnancy-triggered jaundice
  • medication-triggered jaundice
  • abdominal pain
  • fatigue
  • hepatomegaly
Full details

Risk factors

  • family history
  • age 10 to 30 years
  • Iranian Jewish or Moroccan Jewish ethnicity
  • male sex
Full details

Diagnostic tests

1st tests to order

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

Tests to consider

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

Emerging tests

  • urinary leukotriene metabolites

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Anil Dhawan, MBBS, MD, FRCPCH
Anil Dhawan

Professor of Paediatric Hepatology

King's College Hospital

London

UK

Disclosures

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

Disclosures

TAFC declares that he has no competing interests.

Peer reviewers

John T. Jenkins, MB, CHB, FRCP

Consultant Surgeon

St. Mark's Hospital

London

UK

Disclosures

JTJ declares that he has no competing interests.

Nancy Reau, MD

Assistant Professor of Medicine

University of Chicago

Center for Liver Disease

Chicago

IL

Disclosures

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

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