Direct Hyperbilirubinemia in Non-Obstructive Elderly Jaundice Patient - A Case Report

Bilirubin is a product of the breakdown of haemoglobin. Bilirubin is taken up and goes conjugation process within the hepatocyte before transported out from liver to biliary tract. Dubin Johnson syndrome (DJS) is an inherited disorder caused by defect of ABCC2 gene which codes protein production that substantial to transport the conjugated bilirubin out from liver. It presented intermittent jaundice and usually come in young adult rarely in elderly. This rare disorder was not easy to diagnose, often misdiagnosed with extra hepatic obstruction. We present uncommon case of DJS with transaminitis that appears first in elderly. This is a case of previously unrecognized DJS precipitated by pulmonary infection in AIDS patient.