Thyroid Storm Presenting as Acute Liver Failure in a Patient with Graves' Disease

Although mild elevations in liver enzymes are relatively common in thyrotoxicosis, acute liver failure (ALF) is an infrequent occurrence. Despite the emergence of liver transplantation as a viable treatment for ALF, survival rates continue to remain unsatisfactory, coupled with higher rates of postoperative complications and re-transplantation in this group. We present the disease course, management, and outcome of a patient with Graves' disease who presented with ALF secondary to thyroid storm. Thyrotoxicosis should always be included in the differential diagnosis of ALF, as timely diagnosis and management are crucial in achieving survival.