Antifungal induced jaundice unmasking Dubin–Johnson Syndrome in an adult patient: a case report

Background Dubin-Johnson syndrome (DJS) is an autosomal recessive genetic liver disease, characterized by chronic predominantly conjugated hyperbilirubinemia. Most people with DJS are asymptomatic, so their cases are often misdiagnosed and not properly taken care of. Our case illustrates a rare cause of jaundice in adults triggered by antifungal treatment, which is DJS, and the importance of screening for this disease in order to warn the patient before taking any hepatotoxic medication. Case presentation: We report here a case of a 40-year-old North African woman, who complained of chronic jaundice and abdominal pain. The history revealed that the patient had been taking an antifungal treatment for 1 month prior to the onset of jaundice, prescribed for onychomycosis.Biological and radiological examinations were performed, concluding in intrahepatic cholestasis. A liver biopsy was then performed and confirmes DJS. A conservative approach was adopted, with follow-up indicating a favorable outcome. Conclusions : DJS is a rare cause of jaundice in adults. The prognosis is favorable without progression to fibrosis. This entity does not require treatment in adolescents and adults. However, management requires a multimodal care strategy, including avoiding of potential triggers especially hepatotoxic drugs.