Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 5 ( September-October, 2022 ) > List of Articles


The Icteric Riddle: A Diagnostic Conundrum to Diagnose Maternal Dubin–Johnson Syndrome

Keywords : Autosomal-recessive, Dubin–Johnson Syndrome, Jaundice in pregnancy, Liver disease in pregnancy, Ursodeoxycholic acid

Citation Information : The Icteric Riddle: A Diagnostic Conundrum to Diagnose Maternal Dubin–Johnson Syndrome. J South Asian Feder Obs Gynae 2022; 14 (5):625-626.

DOI: 10.5005/jp-journals-10006-2135

License: CC BY-NC 4.0

Published Online: 16-11-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: To diagnose a rare congenital liver disorder, Dubin–Johnson Syndrome (DJS), compounded by pregnancy and its several differential diagnoses that impede the progress toward diagnosis. Background: Icterus, or jaundice, is defined as the yellow discoloration of the skin, more so of the sclera. While it classifies as one of the most common symptoms in medical literature, it gains added significance when it arrives in congruence to pregnancy. And with that added significance comes the increased risk of maternal and fetal morbidities and mortalities. Case description: Here, we discuss a 19-year-old antenatal patient with refractory hyperbilirubinemia whose etiology eluded our team, until a final shot at it through liver biopsy helped us fetch a surprising diagnosis of DJS. Conclusion: A nonfatal clinical syndrome with very few comorbidities, pregnancy at worst, worsens the icteric component without producing too many adverse fetomaternal outcomes. Clinical significance: The aid of a sound algorithm to rule out other more morbid causes of hepatic dysfunction in pregnancy.

  1. Luo Z, Zhang L, Li Y. Clinical pathology of Dubin-Johnson syndrome. Zhonghua Gan Zang Bing Za Zhi 2000;8(1):45–47. PMID: 10712787.
  2. Vinayachandran SN, Anaswara K. Liver disorders in pregnancy: A fetomaternal outcome. J South Asian Feder Obst Gynaecol 2020; 12(3). 167–171. DOI: 10.5005/jp-journals-10006-1788.
  3. Naga VKM, Joseph B, Kalappa MS. Obstetric outcome in women with intrahepatic cholestasis: A 3-year study in a Tertiary Care Hospital in Bengaluru. J South Asian Feder Obst Gynaecol 2019;11(2):103–106. DOI: 10.5005/jp-journals-10006-1662.
  4. Talaga ZJ, Vaidya PN. Dubin-Johnson syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
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