Introduction
Multiple causes could alter liver functions including infections,
biliary disorders, viral or non-viral hepatitis, autoimmunity, and
drugs. Brucellosis, zoonotic infection, presents with unspecific varied
signs and symptoms affecting multiple organs (1). This infection is
widely prevalent in both animals and humans (2). The liver is commonly
involved in both acute and chronic cases of Brucellosis. When infected,
patients may experience a slight increase in transaminase levels and
mild swelling of both the liver and spleen. Occasionally, acute
hepatitis can occur, but it’s usually not the only symptom of infection
(3).
Conjugated hyperbilirubinemia along with normal liver transaminase,
serum alkaline phosphatase (ALP), and jaundice highly suggest
Dubin-Johnson syndrome (DJS). Patients less likely present with mild
abdominal pain, pruritus, nausea, or vomiting. DJS is a rare, chronic
mainly autosomal recessive disease caused by mutations in the gene
encoding for proteins involved in hepatobiliary transport of non-bile
salt organic anions, leading to conjugated hyperbilirubinemia (4).
Mutations in the multidrug resistance-associated protein-2 (MRP-2) gene are responsible for this disorder (4). The diagnosis
of this benign condition is important to avoid unnecessary anxiety or
intervention (5).
Herein, for the first time, we report a case of a 35-year-old man
presenting with jaundice for the first time in his life caused by
brucella hepatitis, that lead to the diagnosis of concomitant DJS.