Liver Dysfunction in Hyperthyroidism

Area of Science:

• Endocrinology
• Hepatology
• Internal Medicine

Background:

• Thyrotoxicosis frequently presents with abnormal liver tests.
• Liver dysfunction in thyrotoxicosis can stem from multiple causes.
• Identifying predictors for thyroid storm in this population is crucial.

Purpose of the Study:

• To characterize clinical and laboratory findings in thyrotoxic patients with liver abnormalities.
• To identify factors predicting thyroid storm in thyrotoxic patients with hepatic dysfunction.

Main Methods:

• Retrospective review of thyrotoxic patients with hepatic dysfunction (January 2015 - January 2021).
• Inclusion of 771 thyrotoxic patients; 43 had abnormal liver tests.
• Univariate and multivariate analyses to identify factors associated with thyroid storm.

Main Results:

• 5.58% of thyrotoxic patients (43/771) exhibited abnormal liver tests.
• Common causes included hyperthyroidism-related hepatitis, congestive hepatopathy, and chronic hepatitis C.
• Younger age, congestive heart failure, and total bilirubin ≥ 3.0 mg/dL predicted thyroid storm.

Conclusions:

• Liver abnormalities are common in thyrotoxicosis, with multifactorial causes.
• Predictive factors for thyroid storm in thyrotoxic patients with liver issues include younger age, heart failure, and elevated bilirubin.
• These findings aid in distinguishing thyroid storm in thyrotoxic patients with hepatic dysfunction.