Which specific condition is characterized by low bilirubin secretion into bile?

The condition characterized by low bilirubin secretion into bile is Dubin-Johnson syndrome. This syndrome is a genetic disorder resulting from a defect in the transport of conjugated bilirubin. In individuals with Dubin-Johnson syndrome, the liver is unable to properly secrete conjugated bilirubin into the bile, leading to its accumulation in the bloodstream and resulting in a mild form of jaundice. The defect affects the hepatic excretion mechanism, which causes an increase in conjugated bilirubin levels in the circulation while often maintaining normal levels of unconjugated bilirubin.

In contrast to Dubin-Johnson syndrome, Gilbert syndrome is associated with reduced levels of unconjugated bilirubin due to decreased activity of the enzyme UDP-glucuronosyltransferase, resulting in mild unconjugated hyperbilirubinemia but not affecting bile secretion. Crigler-Najjar syndrome also deals with defects in bilirubin metabolism, specifically affecting the conjugation of bilirubin but not specifically its secretion into the bile. Hemolytic anemia primarily leads to elevated levels of unconjugated bilirubin due to increased breakdown of red blood cells, which does not pertain directly to the secretion of bilirubin into bile.