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[Hyperthyroidism and cholestasis: a case report].

L Gurioli1, G Babini, R Rizzi

  • 1U.O. di Medicina Interna, Ospedale Civile di Cuorgne.

Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna
|June 1, 1999
PubMed
Summary
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Thyrotoxicosis can cause severe intrahepatic cholestasis, a rare liver condition. Treatment of hyperthyroidism with methimazole normalized liver function and bilirubin levels in a unique patient case.

Area of Science:

  • Hepatology
  • Endocrinology
  • Internal Medicine

Background:

  • Intrahepatic cholestasis is infrequently associated with thyrotoxicosis.
  • When cholestasis occurs in thyrotoxicosis, it is typically linked to congestive heart failure.
  • The direct impact of hyperthyroidism on liver function warrants further investigation.

Observation:

  • A 63-year-old male presented with jaundice and hyperthyroidism.
  • Elevated plasma bilirubin reached 27.41 mg/dL.
  • Exclusion of heart failure, autoimmune hepatitis, and viral hepatitis was confirmed through comprehensive examinations.

Findings:

  • Hyperthyroidism-induced intrahepatic cholestasis can occur without congestive heart failure.
  • Methimazole therapy led to simultaneous normalization of thyroid hormone and plasma bilirubin levels.

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  • The patient's extremely high bilirubin levels in the absence of other comorbidities are unprecedented.

    • Implications:

    • This case highlights a rare but severe hepatic manifestation of thyrotoxicosis.
    • Effective management of hyperthyroidism is crucial for resolving cholestasis.
    • Further research is needed to elucidate the mechanisms linking thyroid dysfunction and intrahepatic cholestasis.