Abnormalities of Liver Function Tests In Thyrotoxicosis

Thompson, Prentice; Strum, Daniel; Boehm, Timothy M.; Wartofsky, Léonard

doi:10.1093/milmed/143.8.548

Cited by 64 publications

(27 citation statements)

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“…Thompson et al presented 85 patients with hyperthyroidism and abnormal liver function tests. The highest bilirubin value reported in this cohort was 3.5 mg/dL [13] comparing to our patient which presented with a more severe hyperbilirubinemia of 18.1 mg/dL (0.3-1.2 mg/dL), which is very rare. In the setting of hyperthyroidism, only three cases in literature have reported hyperbilirubinemia to this degree, with total bilirubin levels of 16.7 mg/dL, 18.9 mg/dL and 35 mg/dL [14][15][16].…”

Section: Discussioncontrasting

confidence: 62%

Severe cholestatic jaundice secondary to hyperthyroidism

Usta¹,

Massaad²,

Parekh³

et al. 2013

IJCRI

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Introduction:Hyperthyroidism is a known cause of nonspecific abnormalities in liver biochemitries; most commonly mild elevations in serum bilirubin and liver enzymes. Case Report: A case of severe cholestatic jaundice secondary to Grave's disease. The patient is a 28yearoldAfricanAmerican male who presented to the emergency room with chronic diarrhea, weight loss and jaundice. At presentation, his liver enzymes were elevated in a cholestatic pattern and his bilirubin was 21.4 mg/dL. Upon treatment with propranolol and propylthouracil, his diarrhea, pruritus, jaundice, and liver enzymes quickly improved. His bilirubin returned to normal over a period of two months. Conclusion: While severe intrahepatic cholestasis and jaundice due to hyperthyroidism is rare, the diagnosis should be considered in patients presenting with manifestations of liver disease, as appropriate treatment of hyperthyroidism results in resolution of jaundice.

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Section: Discussioncontrasting

confidence: 62%

Severe cholestatic jaundice secondary to hyperthyroidism

Usta¹,

Massaad²,

Parekh³

et al. 2013

IJCRI

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“…For these reasons, the levels of free T4 in our case were not always consistent with the ALT levels. However, thyrotoxicosis and MMI can induce liver injury (17)(18)(19). In general, thyrotoxicosis-induced liver injury improves after thyrotoxicosis is removed by proper treatment for hyperthyroidism.…”

Section: Discussionmentioning

confidence: 99%

Hyperthyroidism Improves the Pathological Condition of Nonalcoholic Steatohepatitis: A Case of Nonalcoholic Steatohepatitis with Graves' Disease

et al. 2016

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Abstract3,5,3'-triiodo-L-thyronine regulates the glucose metabolism, lipid metabolism, and hepatic steatosis. Several groups have shown the relationships between hypothyroidism and nonalcoholic fatty liver and hypothyroidism and nonalcoholic steatohepatitis (NASH). However, the effect of hyperthyroidism on NASH has not yet been investigated. We herein report effects of thyroid hormone on the pathological condition of NASH in a patient with NASH complicated by Graves' disease. In our case, the liver enzyme level improved with the increasing thyroid hormone level; however, the liver enzyme level was aggravated with the improving thyroid hormone level. Therefore, hyperthyroidism may improve the pathological condition of NASH.

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“…An increase in the aspartate aminotransferase and alanine aminotransferase was reported in 27 and 37% of patients with tyrotoxicosis, respectively (51). This could be explained by relative hypoxia in the perivenular regions, secondary to an increase in hepatic oxygen demand without an appropriate increase in hepatic blood flow (39).…”

Section: Discussionmentioning

confidence: 99%

Thyroid hormone inhibits biliary growth in bile duct-ligated rats by PLC/IP₃/Ca²⁺-dependent downregulation of SRC/ERK1/2

Fava¹,

Ueno²,

Glaser³

et al. 2007

American Journal of Physiology-Cell Physiology

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.-The role of the thyroid hormone agonist 3,3Ј,5 L-tri-iodothyronine (T3) on cholangiocytes is unknown. We evaluated the in vivo and in vitro effects of T3 on cholangiocyte proliferation of bile duct-ligated (BDL) rats. We assessed the expression of ␣ 1-, ␣2-, ␤1-, and ␤2-thyroid hormone receptors (THRs) by immunohistochemistry in liver sections from normal and BDL rats. BDL rats were treated with T3 (38.4 g/day) or vehicle for 1 wk. We evaluated 1) biliary mass and apoptosis in liver sections and 2) proliferation in cholangiocytes. Serum-free T3 levels were measured by chemiluminescence. Purified BDL cholangiocytes were treated with 0.2% BSA or T3 (1 M) in the absence/presence of U-73122 (PLC inhibitor) or BAPTA/AM (intracellular Ca 2ϩ chelator) before measurement of PCNA protein expression by immunoblots. The in vitro effects of T3 (1 M) on 1) cAMP, IP3, and Ca 2ϩ levels and 2) the phosphorylation of Src Tyr139 and Tyr530 (that, together, regulate Src activity) and ERK1/2 of BDL cholangiocytes were also evaluated. ␣ 1-, ␣2-, ␤1-, and ␤2-THRs were expressed by bile ducts of normal and BDL rats. In vivo, T3 decreased cholangiocyte proliferation of BDL rats. In vitro, T3 inhibition of PCNA protein expression was blocked by U-73122 and BAPTA/AM. Furthermore, T3 1) increased IP3 and Ca 2ϩ levels and 2) decreased Src and ERK1/2 phosphorylation of BDL cholangiocytes. T3 inhibits cholangiocyte proliferation of BDL rats by PLC/IP3/Ca 2ϩ -dependent decreased phosphorylation of Src/ERK1/2. Activation of the intracellular signals triggered by T3 may modulate the excess of cholangiocyte proliferation in liver diseases.

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Abnormalities of Liver Function Tests In Thyrotoxicosis

Cited by 64 publications

References 0 publications

Severe cholestatic jaundice secondary to hyperthyroidism

Severe cholestatic jaundice secondary to hyperthyroidism

Hyperthyroidism Improves the Pathological Condition of Nonalcoholic Steatohepatitis: A Case of Nonalcoholic Steatohepatitis with Graves' Disease

Thyroid hormone inhibits biliary growth in bile duct-ligated rats by PLC/IP₃/Ca²⁺-dependent downregulation of SRC/ERK1/2

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Abnormalities of Liver Function Tests In Thyrotoxicosis

Cited by 64 publications

References 0 publications

Severe cholestatic jaundice secondary to hyperthyroidism

Severe cholestatic jaundice secondary to hyperthyroidism

Hyperthyroidism Improves the Pathological Condition of Nonalcoholic Steatohepatitis: A Case of Nonalcoholic Steatohepatitis with Graves' Disease

Thyroid hormone inhibits biliary growth in bile duct-ligated rats by PLC/IP3/Ca2+-dependent downregulation of SRC/ERK1/2

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Thyroid hormone inhibits biliary growth in bile duct-ligated rats by PLC/IP₃/Ca²⁺-dependent downregulation of SRC/ERK1/2