{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:14:15Z","timestamp":1788156855879,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Dubin\u2010Johnson Syndrome (DJS) is a rare inherited disorder characterized by isolated conjugated hyperbilirubinemia without significant liver damage. This syndrome is often diagnosed incidentally during routine blood tests, as it typically presents with minimal or no symptoms. The disease results from a genetic defect in the\n                    <jats:italic>ABCC2<\/jats:italic>\n                    gene, which encodes the MRP2 protein responsible for transporting conjugated bilirubin out of hepatocytes. In individuals with DJS, the impaired function of MRP2 leads to the accumulation of conjugated bilirubin in the liver and bloodstream. This case report presents a 31\u2010year\u2010old female who, during pregnancy, developed icterus, which raised concerns about possible liver disease or viral hepatitis. However, further investigation revealed no significant liver dysfunction or risk factors for viral hepatitis. Laboratory tests showed elevated total and direct bilirubin levels, with normal liver enzymes, thus prompting further evaluation. Ultrasound imaging of the liver and biliary system revealed no signs of obstruction, and tests for viral hepatitis were negative. The patient's clinical history of icterus since childhood, combined with the laboratory findings, led to the suspicion of DJS. Notably, urine coproporphyrin analysis demonstrated a characteristic increase in coproporphyrin I, further supporting the diagnosis. Although DJS does not typically require treatment, the patient was provided with genetic counseling to inform her and her family about the condition and potential inheritance patterns. DJS presents a diagnostic challenge due to its subtle clinical features and the need to differentiate it from other causes of icterus, especially in pregnancy. This case highlights the importance of considering rare genetic disorders in the differential diagnosis of icterus and emphasizes the role of genetic testing in confirming the diagnosis. Early recognition of DJS allows for appropriate management and genetic counseling, ensuring that affected individuals can lead a normal life without major complications.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.73267","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:19:26Z","timestamp":1786015166000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Rare Diagnosis of Dubin\u2010Johnson Syndrome During Pregnancy: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"given":"Said Reza Modares","family":"Mousavi","sequence":"first","affiliation":[{"name":"Internal Medicine Department Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farab","family":"Pourhasan","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Abadan University of Medical Sciences  Abadan Iran"},{"name":"Student of Research Committee, Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1507-8815","authenticated-orcid":false,"given":"Pouria Ahmadi","family":"Simab","sequence":"additional","affiliation":[{"name":"Universal Scientific Education and Research Network (USERN), Tehran  Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Beikmohammadi\u2010Gharehsaghghal","sequence":"additional","affiliation":[{"name":"Student of Research Committee, Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryoush","family":"Kaini\u2010Shamsabadi","sequence":"additional","affiliation":[{"name":"Student of Research Committee, Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3517-5535","authenticated-orcid":false,"given":"Elaheh","family":"Karimzadeh\u2010Soureshjani","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Abadan University of Medical Sciences  Abadan Iran"},{"name":"Student of Research Committee, Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"J. R.ChowdhuryandN. R.Chowdhury \u201cInherited Disorders Associated With Conjugated Hyperbilirubinemia in Adults. UpToDate \u201d(2024) K. D. Lindor (Ed.)."},{"key":"e_1_2_13_3_1","volume-title":"Dubin\u2010Johnson Syndrome","author":"Talaga Z.","year":"2023"},{"key":"e_1_2_13_4_1","volume-title":"Harrison's Principles of Internal Medicine","author":"Loscalzo J.","year":"2022"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.crwh.2020.e00214","article-title":"Extreme Elevations of Alkaline Phosphatase in Pregnancy: A Case Report","volume":"27","author":"Stanley Z.","year":"2020","journal-title":"Case Report Womens Health"},{"issue":"3","key":"e_1_2_13_6_1","article-title":"Dubin\u2010Johnson Syndrome: A Case Report","volume":"15","author":"Siddiqui A. H.","year":"2023","journal-title":"Cureus"},{"issue":"2","key":"e_1_2_13_7_1","article-title":"A Case of Dubin\u2010Johnson Syndrome in Pregnancy","volume":"11","author":"Gupta A.","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.2049"},{"key":"e_1_2_13_9_1","unstructured":"R. H.Lee N.Reau andK. D.Lindor \u201cAcute Fatty Liver of Pregnancy \u201d(2024)."},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.409"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/FM9.0000000000000031"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2021.03.006"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/egastro-2023-100039"},{"issue":"5","key":"e_1_2_13_14_1","first-page":"4477","article-title":"Literature Review and Report of Three Cases of Dubin\u2010Johnson Syndrome Related to ABCC2 Gene Mutations in Children","volume":"13","author":"You S. J.","year":"2021","journal-title":"American Journal of Translational Research"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i4.878"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73267","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73267","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:22:31Z","timestamp":1788153751000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ccr3.73267"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73267","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.174851284.46015176\/v1","asserted-by":"object"}]},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-05-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73267"}}