A report of three cases of jaundice with thyrotoxicosis

Akande, T. O.; Wo, Balogun

doi:10.4314/ahs.v13i3.48

Cited by 6 publications

(7 citation statements)

References 14 publications

(16 reference statements)

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“…Other options that have been successfully used in cases of antithyroid-induced hepatotoxicity include substituting antithyroid agents, use of cholestyramine and radioiodine. 29 Three patients in our study had antithyroid drug benzylthiouracil prior to radical approach, which consisted of radioactive iodine and total thyroidectomy. The metabolic process of 131I usually does not cause radiation damage to the liver.…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism and hepatic dysfunction: Report of 17 cases

et al. 2020

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Aims: Hyperthyroidism has been known to be associated with abnormalities of serum liver chemistry. The objective of our study is to describe clinical, biochemical and therapeutic features of hepatic dysfunction in hyperthyroidism. Methods and Results: This retrospective study was conducted on patients hospitalized in our endocrinology department over 20 years. We included patients with untreated and noniatrogenic hyperthyroidism among whom biochemical findings noted hepatic dysfunction and excluded those with concomitant liver disease. Our population is composed of 10 men and 7 women. The average age was 41.4 years. The mean serum level of free thyroxine was 83.8 pmol/L. The serum thyrotropin level was below the detection limit in 10/17 cases. Graves' disease was the most frequently found etiology of hyperthyroidism. Fourteen patients had hyperthyroidism's complications. Eleven patients manifested congestive heart failure. Hepatic dysfunction was moderate and severe in eight and two cases, respectively. Fifteen patients had cholestasis, associated with jaundice in five cases. Hepatocellular injury and synthetic liver dysfunction were noted in seven and five cases, respectively. Thyroid peroxidase antibodies were positively correlated with the serum level of bilirubin (ρ = 0.695; P = 0.038). A negative correlation was noted between alanine aminotransferase and left ventricular ejection fraction (ρ = −0.812; P = 0.05). Radioactive iodine was indicated in 15/17 cases. Follow-up liver tests were performed in 11 cases. They all had normalized hepatic function once euthyroidism restored. Conclusion: Liver injury in hyperthyroidism is relatively common, ranging from mild to severe. Therefore, patients presenting unexplained hepatic abnormalities require close examination and an evaluation of the thyroid function should be sought.

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Section: Discussionmentioning

confidence: 99%

Hyperthyroidism and hepatic dysfunction: Report of 17 cases

et al. 2020

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“…Although the pattern of biochemical hepatic abnormalities and hepatic injury in the setting of hyperthyroidism is variable in character and severity, it appears to be predominantly hepatitic, with a few case reports demonstrating a cholestatic pattern . The first report of hepatic necrosis in a patient with thyrotoxicosis occurred in 1874 .…”

Section: Introductionmentioning

confidence: 99%

“…Further studies demonstrated that the degree of biochemical hyperthyroxinaemia does not correlate with cellular and ultrastructural abnormalities . Liver abnormalities were mostly hepatitic with predominantly serum aspartate transaminotransferase (AST), alanine aminotransferase (ALT), and bilirubin elevations, with some increased serum alkaline phosphatase (AP) and gamma‐glutamyltransferase (GGT) concentrations . However, AP elevations may not necessarily originate from the liver and can represent elevations in the bone isoenzyme .…”

Section: Introductionmentioning

confidence: 99%

“…There is limited understanding regarding the patterns of biochemical liver abnormality changes that occur upon treatment of hyperthyroidism. The relationships between use of anti‐thyroid drugs and biochemical liver abnormalities have been described in a few small series, while those for other therapies in hyperthyroidism (radioactive iodine and surgery) have been rarely described . This retrospective study investigates the patterns of liver biochemical abnormalities in patients at our institution with a new diagnosis of thyrotoxicosis.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of abnormal liver biochemical tests in hyperthyroidism

Lin

Shekar

et al. 2017

Clinical Endocrinology

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Objective Abnormal serum liver function tests are common in patients with untreated thyrotoxicosis, even prior to the initiation of antithyroidal medications that may worsen their severity. There is a wide range of the incidence of these abnormalities in the published literature. The aim of this study was to assess the risks factors and threshold of thyrotoxicosis severity for developing an abnormal liver biochemical test upon the diagnosis of new thyrotoxicosis. Design Single-institution retrospective cohort study. Patients Patients ≥18 years old receiving medical care at a large, academic, urban U.S. medical center between 2002–2016. Measurements Inclusion criteria were a serum thyroid stimulating hormone [TSH] concentration < 0.3 mIU/L or ICD-9 code for thyrotoxicosis, with thyrotoxicosis confirmed by either a concurrent elevated serum triiodothyronine (T3) and/or thyroxine (T4) concentration [total or free] within 3 months), and an available liver biochemical test(s) within 6 months of thyrotoxicosis. The biochemical liver tests assessed were serum aspartate transaminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), gamma-glutamyltransferase (GGT), total bilirubin, and conjugated bilirubin concentrations. Results In this cohort of 1,514 subjects, the overall incidence of any biochemical liver test abnormality within 6 months of thyrotoxicosis was 39%. An initial serum TSH concentration <0.02 mIU/L, male gender, and African-American race were significant predictors of an abnormal serum liver biochemical test within 6 months of the diagnosis of new-onset untreated thyrotoxicosis. Conclusions This study identifies risk factors for patients who develop an abnormal serum liver biochemical test result within 6 months of a diagnosis of untreated thyrotoxicosis.

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“…Finally we have case reports on medication errors in anesthetic practice 46 ; vitamin B12 deficiency presenting with acute confusion 47 ; and cases of jaundice with thyrotoxicosis. 48 It is high time communicable diseases received the attention they deserve in the context of infections and dysfunctional health systems in LMICs.…”

Section: Editorialmentioning

confidence: 99%

Editorial: Non-communicable diseases are reaching epidemic proportions: evidence from low and middle income countries

Tumwine

2013

Afr H. Sci.

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A report of three cases of jaundice with thyrotoxicosis

Cited by 6 publications

References 14 publications

Hyperthyroidism and hepatic dysfunction: Report of 17 cases

Hyperthyroidism and hepatic dysfunction: Report of 17 cases

Incidence of abnormal liver biochemical tests in hyperthyroidism

Editorial: Non-communicable diseases are reaching epidemic proportions: evidence from low and middle income countries

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