When Birth Control Turns Biliary: A Rare Case of Profound Hyperbilirubinemia From Oral Contraceptives

Authors

• Taiwo Ajani, The University of Texas Rio Grande ValleyFollow
• Aura Calderon, The University of Texas Rio Grande ValleyFollow
• Jose J. Loayza Pintado, The University of Texas Rio Grande ValleyFollow
• Nayiri Derian, The University of Texas Rio Grande ValleyFollow
• Catherine Matos, The University of Texas Rio Grande ValleyFollow
• Ivan Mogollon, The University of Texas Rio Grande ValleyFollow
• Andres Suarez Parraga, The University of Texas Rio Grande ValleyFollow

Document Type

Article

Publication Date

4-2026

Abstract

Oral contraceptives (OCs) are extensively utilized and generally considered safe (reference); nonetheless, infrequent hepatobiliary complications such as cholestasis and hyperbilirubinemia have been documented, particularly among individuals with a genetic predisposition. We present a case involving a 19-year-old female who exhibited significant conjugated hyperbilirubinemia shortly after the commencement of OC therapy. Comprehensive investigations ruled out alternative causes, and the findings from liver biopsy, in conjunction with the clinical context, indicated an estrogen-induced cholestatic injury, likely revealing an underlying Dubin–Johnson syndrome. This case underscores the critical necessity of acknowledging hepatic adverse effects associated with estrogen as well as the influence of genetic susceptibility in drug-related adverse events.

Comments

© 2026 American Federation for Medical Research.
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).  

Recommended Citation

Ajani, T., Calderon, A., Loayza Pintado, J., Derian, N., Matos, C., Mogollon, I., & Suarez, A. (2026). When Birth Control Turns Biliary: A Rare Case of Profound Hyperbilirubinemia From Oral Contraceptives. Journal of Investigative Medicine High Impact Case Reports, 14, 23247096261435540. https://doi.org/10.1177/23247096261435540

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Publication Title

Journal of Investigative Medicine High Impact Case Reports

DOI

10.1177/23247096261435540

Academic Level

resident

Mentor/PI Department

Internal Medicine