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Dubin-Johnson syndrome
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Dubin-Johnson syndrome

Dubin-Johnson syndrome is a genetic condition characterized by jaundice, often appearing in adolescence or early adulthood, due to impaired bilirubin excretion from the liver.

Overview

Dubin-Johnson syndrome is a condition characterized by jaundice, which is a yellowing of the skin and . In most affected people jaundice appears during adolescence or early adulthood. Jaundice is typically the only feature of Dubin-Johnson syndrome, but some people can experience weakness, mild abdominal pain, nausea, or vomiting. In most people with Dubin-Johnson syndrome, certain deposits build up in t but do not seem to impair liver function. The deposits make the liver appear black when viewed with medical imaging.

Rarely, jaundice develops soon after birth in individuals with Dubin-Johnson syndrome. Affected infants typically also have enlarged livers (hepatomegaly) and a severely reduced ability to produce and release a digestive fluid called bile (cholestasis). As these children get older, their liver problems go away and they usually do not have any related health problems later in life.

Frequency

The prevalence of Dubin-Johnson syndrome is unknown. It appears to be most common in Iranian and Moroccan Jews living in Israel, with 1 in 1,300 individuals affected. Additionally, several people in the Japanese population have been diagnosed with Dubin-Johnson syndrome. This condition appears to be less common in other populations.

Causes

Dubin-Johnson syndrome is caused by changes in a gene known as ABCC2. The ABCC2 gene provides instructions for making a protein that transports certain substances out of cells so they can be released (excreted) from the body. For example, this protein transports a substance called bilirubin out of liver cells and into bile (a digestive fluid produced by the liver). Bilirubin is produced during the breakdown of old red blood cells and has an orange-yellow tint.

ABCC2 gene mutations result in the production of a protein with reduced or absent activity that cannot effectively transport substances out of cells. These mutations particularly affect moving bilirubin into bile. As a result, bilirubin accumulates in the body, causing a condition called hyperbilirubinemia. The buildup of bilirubin in the body causes the yellowing of the skin and whites of the eyes in people with Dubin-Johnson syndrome. The black liver in affected individuals is due to a buildup of different substance normally transported out of the liver by the protein produced from the ABCC2 gene.

Learn more about the gene associated with Dubin-Johnson syndrome

  • ABCC2

Inheritance

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Other Names for This Condition

  • Black liver-jaundice syndrome
  • Chronic idiopathic jaundice
  • Chronic idiopathic jaundice with pigmented liver
  • DJS
  • Dubin-Sprinz syndrome
  • Hyperbilirubinemia II
  • Hyperbilirubinemia, Dubin-Johnson type
  • Jaundice, chronic idiopathic

Frequently Asked Questions

It follows an autosomal recessive pattern. If both parents carry a mutation in ABCC2, each pregnancy has a 25 % chance of being affected, a 50 % chance of being a carrier, and a 25 % chance of being unaffected. Genetic counseling is recommended for families.
liver panel showing normal or only mildly elevated alkaline phosphatase, normal transaminases, and a conjugated hyperbilirubinemia is typical. A key diagnostic test is the “direct bilirubin” fraction; in Dubin‑Johnson it is elevated. A liver biopsy may reveal black pigment deposits, and genetic testing for ABCC2 mutations confirms the diagnosis.
Most people with Dubin‑Johnson have normal liver function tests and no progressive liver disease. The pigment deposits do not impair hepatocyte function, and complications are rare. Regular monitoring is usually sufficient.
There are no specific dietary restrictions, but patients should avoid hepatotoxic drugs (e.g., certain antibiotics, acetaminophen in high doses) and excessive alcohol. Discuss any new medications with a clinician before starting.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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