Urinary Coproporphyrin Isomer Distribution in the Dubin-Johnson Syndrome

Urinary coproporphyrinisomer distribution was studied in 13 patients suffering from the Dubin-Johnsonsyndromeand several control groups. In patients with the Dubin-Johnson syndrome the isomer distribution was quite the reverse to that of normal persons. The urinary isomer distribution was in the normal range in patients with Gilbert’s syndrome, hemolytic jaundice, and fatty liver. In many patients with different acute and chronic liver diseases,a clear deviation from the normal urinary isomer distribution was seen. There was, however, no overlapping with the Dubin-Johnson syndrome. Even the fecal coproporphyrin isomer distribution deviated sig-nificantly from the normal in favor of Isomer I. IT HAS BEEN KNOWN since the end of the last century that an increased porphyrin excretion is a common finding in liver diseases (1). The in-crease of porphyrin excretion was later shown to be mainly due to coproporphyrin (2). A clear deviation from the normal distribution of urinary coproporphyrin Isomers I and III in many cases of liver cirrhosis, obstructive jaundice, and chiorpromazine jaundice has also been noted (3). The purpose of this preliminary report is to demonstrate the value of urinary coproporphyrin isomer analysis when the syndrome de-scribed by Dubin and Johnson (4) is to be differentiated from other liver diseases and diseases which may cause intermittent jaundice. Material and Methods The material consisted of 13 patients suffering from the Dubin-Johnson syndrome. The controls were as follows: 30 healthy persons, 10 patients with Gilbert’s syndrome, 3 with hemolytic anemia, 7 with viral hepatitis, 10 with ol)structive jaundice, 15 with hepatic cirrhosis, 3 with fatty liver, 7 with cardiac jaundice, and 6 with jaundice due t