A case with dubin-johnson syndrome complicated by chronic hepatitis with a liver of normal appearance and a secondary rise in oral bile acid tolerance test

Abstract

A case with Dubin-Johnson syndrome (DJS) complicated by chronic hepatitis is reported. A 22-year-old man, who had an episode of acute hepatitis two years previously, admitted to the hospital because of persistent jaundice. Liver function test showed a moderate increase in serum level of transaminase and conjugated bilirubin. Bromsulfophthalein test revealed reincrease of serum BSP level. Fasting total bile acid level was high plasma clearance study of orally administered ursodeoxycholic acid showed secondary rise of total bile acid after 90 min reaching a peak at 120 min suggesting disturbances in bile acid metabolism. Peritoneoscopic study demonstrated almost normal liver with normal color. Microscopic findings of the liver were those of chronic persistent hepatitis and brown pigments were seen in the hepatocytes mainly in centrilobular areas. Clinical features and laboratory findings of the cases with DJS with chronic hepatitis were reviewed and results in plasma clearance study of bile acid was discussed. © 1984, The Japan Society of Hepatology. All rights reserved.