Dubin-Johnson syndrome

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Dubin-Johnson syndrome

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Questions

USMLE® Step 1 style questions USMLE

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A 51-year-old man comes to his outpatient provider for evaluation of epigastric abdominal pain and unintentional weight loss. The symptoms began 6 months ago and the patient has lost 4 kg (8.8 lb) during this time period. Review of systems is notable for fatigue and pruritus over this same time period. Past medical history is notable for alcohol use disorder. The patient has a 35-pack-year smoking history. In the office, his temperature is 37.6°C (99.7°F), blood pressure is 125/77 mmHg, and pulse is 72/min. Physical examination shows an enlarged, palpable, but non-tender, gallbladder. Examination of the patient’s eyes reveals the following finding:  


Reproduced from: Wikimedia Commons   
Cardiac and pulmonary exams are noncontributory. Serum carbohydrate antigen 19-9 levels are elevated. Which of the following laboratory findings would most likely be present in this patient?  

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Dubin-Johnson syndrome p. 400, 400

Summary

Dubin-Johnson syndrome is a rare autosomal genetic disorder characterized by some elevation of conjugated bilirubin but no other signs of injury to the hepatocytes. It's also associated with a black liver due to the deposition of a pigment similar to melanin. Dubin-Johnson syndrome is generally asymptomatic, and no treatment is usually needed.

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