Liver Dysfunction in a Patient with Graves’ Disease
Abstrak
Liver dysfunction can occur in patients presenting with thyrotoxicosis, due to several different aetiologies. A 42-year-old man had mild liver dysfunction on presentation with hyperthyroidism due to Graves’ disease (GD): ALT 65 (0–45 IU/L), fT4 41.2 (9–23 pmol/L), fT3 > 30.7 (2.4–6 pmol/L), and TSH < 0.01 (0.3–4.2 mIU/L). His liver dysfunction worsened following the initiation of the antithyroid drug (ATD) carbimazole (CBZ), with ALT reaching a zenith of 263 IU/L at 8 weeks following presentation. Consequently, CBZ was stopped, and he was managed with urgent radioiodine therapy. His liver function tests (LFTs) improved within 1 week of stopping carbimazole (ALT 74 IU/L). Thionamide-induced liver dysfunction is more typically associated with a ‘cholestatic’ pattern, although he had a ‘hepatitic’ pattern of liver dysfunction. The risk of liver dysfunction in GD increases with older age and higher titres of thyroid-stimulating hormone receptor antibody (TRAb). This review of the literature seeks to explore the possible causes of liver dysfunction in a patient presenting with hyperthyroidism, including thyrotoxicosis-induced liver dysfunction, ATD-related liver dysfunction, and the exacerbation of underlying unrelated liver disease.
Penulis (6)
Filipa Campos
Angelica Sharma
Bijal Patel
Deborah Papadopoulou
Alexander N. Comninos
Ali Abbara
Akses Cepat
- Tahun Terbit
- 2024
- Bahasa
- en
- Total Sitasi
- 4×
- Sumber Database
- CrossRef
- DOI
- 10.3390/jcm13226968
- Akses
- Open Access ✓