eMedicine Specialties > Pediatrics: General Medicine > Gastroenterology
Dubin-Johnson Syndrome: Treatment & Medication
Updated: Nov 17, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Treatment
Medical Care
Evaluation for Dubin-Johnson syndrome (DJS) can usually be conducted on an outpatient, noninvasive basis. Treatment is generally not required.
Consultations
- Gastroenterologist
- Geneticist
Medication
Drug therapy is not currently a component of the standard of care for Dubin-Johnson syndrome (DJS) because it is a benign syndrome.
- In one case report of neonatal DJS with severe cholestasis, phenobarbital significantly decreased serum levels of bilirubin and bile acids.6 Because of adverse effects, long-term phenobarbital therapy cannot be recommended.
- Rifampicin (RIF) and ursodeoxycholic acid (UDCA) therapy have beneficial effects in chronic cholestatic diseases. These may result, in part, from the induction of MRP2 expression in the liver and kidney. However, neither an indication nor a general role for these agents in DJS has been defined.23
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| Overview: Dubin-Johnson Syndrome |
| Differential Diagnoses & Workup: Dubin-Johnson Syndrome |
Treatment & Medication: Dubin-Johnson Syndrome |
| Follow-up: Dubin-Johnson Syndrome |
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References
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Habashi SL, Lambiase L R. Dubin-Johnson Syndrome. eMedicine from WebMD [serial online]. October 2006;Available at http://emedicine.medscape.com/article/173517-overview.
Paulusma CC, Kool M, Bosma PJ, et al. A mutation in the human canalicular multispecific organic anion transporter gene causes the Dubin-Johnson syndrome. Hepatology. Jun 1997;25(6):1539-42. [Medline].
Toh S, Wada M, Uchiumi T, et al. Genomic structure of the canalicular multispecific organic anion-transporter gene (MRP2/cMOAT) and mutations in the ATP-binding-cassette region in Dubin-Johnson syndrome. Am J Hum Genet. Mar 1999;64(3):739-46. [Medline].
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Frank M, Doss M, de Carvalho DG. Diagnostic and pathogenetic implications of urinary coproporphyrin excretion in the Dubin-Johnson syndrome. Hepatogastroenterology. Feb 1990;37(1):147-51. [Medline].
van Kuijck MA, Kool M, Merkx GF, et al. Assignment of the canalicular multispecific organic anion transporter gene (CMOAT) to human chromosome 10q24 and mouse chromosome 19D2 by fluorescent in situ hybridization. Cytogenet Cell Genet. 1997;77(3-4):285-7. [Medline].
Jedlitschky G, Hoffmann U, Kroemer HK. Structure and function of the MRP2 (ABCC2) protein and its role in drug disposition. Expert Opin Drug Metab Toxicol. Jun 2006;2(3):351-66. [Medline].
Keitel V, Kartenbeck J, Nies AT, Spring H, Brom M, Keppler D. Impaired protein maturation of the conjugate export pump multidrug resistance protein 2 as a consequence of a deletion mutation in Dubin-Johnson syndrome. Hepatology. Dec 2000;32(6):1317-28. [Medline].
Zlotogora J. Hereditary disorders among Iranian Jews. Am J Med Genet. Jul 31 1995;58(1):32-7. [Medline].
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Rocchi E, Balli F, Gibertini P, Trenti T, et al. Coproporphyrin excretion in healthy newborn babies. J Pediatr Gastroenterol Nutr. Jun 1984;3(3):402-7. [Medline].
Mayatepek E, Lehmann WD. Defective hepatobiliary leukotriene elimination in patients with the Dubin-Johnson syndrome. Clin Chim Acta. May 30 1996;249(1-2):37-46. [Medline].
Bar-Meir S, Baron J, Seligson U, Gottesfeld F, Levy R, Gilat T. 99mTc-HIDA cholescintigraphy in Dubin-Johnson and Rotor syndromes. Radiology. Mar 1982;142(3):743-6. [Medline].
Shimizu T, Tawa T, Maruyama T, Oguchi S, Yamashiro Y, Yabuta K. A case of infantile Dubin-Johnson syndrome with high CT attenuation in the liver. Pediatr Radiol. Apr 1997;27(4):345-7. [Medline].
Kitamura T, Alroy J, Gatmaitan Z, et al. Defective biliary excretion of epinephrine metabolites in mutant (TR-) rats: relation to the pathogenesis of black liver in the Dubin-Johnson syndrome and Corriedale sheep with an analogous excretory defect. Hepatology. Jun 1992;15(6):1154-9. [Medline].
Regev RH, Stolar O, Raz A, Dolfin T. Treatment of severe cholestasis in neonatal Dubin-Johnson syndrome with ursodeoxycholic acid. J Perinat Med. 2002;30(2):185-7. [Medline].
Arias IM, Blumberg W. The pigment in Dubin-Johnson syndrome. Gastroenterology. Oct 1979;77(4 Pt 1):820-1. [Medline].
Hashimoto K, Uchiumi T, Konno T, et al. Trafficking and functional defects by mutations of the ATP-binding domains in MRP2 in patients with Dubin-Johnson syndrome. Hepatology. Nov 2002;36(5):1236-45. [Medline].
Tate G, Li M, Suzuki T, Mitsuya T. A new mutation of the ATP-binding cassette, sub-family C, member 2 (ABCC2) gene in a Japanese patient with Dubin-Johnson syndrome. Genes Genet Syst. Apr 2002;77(2):117-21. [Medline].
Further Reading
Keywords
Dubin-Johnson syndrome, DJS, conjugated hyperbilirubinemia, multidrug resistant protein 2, MRP2, hyperbilirubinemia II, jaundice, chronic idiopathic jaundice, Sprinz-Nelson syndrome, Gilbert syndrome, Crigler-Najjar syndrome, Rotor syndrome, jaundice, cholestasis, hepatomegaly
Treatment & Medication: Dubin-Johnson Syndrome