Dubin-Johnson syndrome (DJS) is a disorder passed down through families (inherited). In this condition, you may have mild jaundice throughout life.
DJS is a very rare genetic disorder. In order to inherit the condition, a child must get a copy of the defective gene from both parents.
The syndrome interferes with the body's ability to move bilirubin through the liver into the bile. When the liver and spleen break down worn out red blood cells, bilirubin is produced. Bilirubin normally moves into the bile, which is produced by the liver. It then flows into the bile ducts, past the gallbladder, and into the digestive system.
Bile is a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acid...
When bilirubin is not properly transported into the bile, it builds up in the bloodstream. This causes the skin and the whites of the eyes to turn yellow. This is called jaundice. Severely high levels of bilirubin can damage the brain and other organs.
People with DJS have lifelong mild jaundice that may be made worse by:
- Birth control pills
- Environmental factors that affect the liver
Mild jaundice, which may not appear until puberty or adulthood, is most often the only symptom of DJS.
Exams and Tests
The following tests can help diagnose this syndrome:
- Liver biopsy
- Liver enzyme levels (blood test)
- Serum bilirubin
- Urinary coproporphyrin levels, including coproporphyrin I level
No specific treatment is required.
The outlook is very positive. DJS generally does not shorten a person's lifespan.
Complications are unusual, but may include the following:
- Abdominal pain
- Severe jaundice
When to Contact a Medical Professional
Call your health care provider if any of the following occurs:
- Jaundice is severe
- Jaundice gets worse over time
- You also have abdominal pain or other symptoms (which may be a sign that another disorder is causing the jaundice)
If you have a family history of DJS, genetic counseling may be helpful if you plan to have children.
Korenblat KM, Berk PD. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 138.
Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 21.
Roy-Chowdhury J, Roy-Chowdhury N. Bilirubin metabolism and its disorders. In: Sanyal AJ, Terrault N, eds. Zakim and Boyer's Hepatology: A Textbook of Liver Disease. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 58.
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
Review Date: 7/13/2020
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.