Graves' disease and autoimmune hepatitis overlap syndrome with coincidental simultaneous presentation in a pediatric...

Graves' disease (GD) and autoimmune hepatitis (AIH) represent distinct autoimmune disorders affecting the thyroid and liver, respectively.

This report discusses a case of a 13-year-old boy with rare coexistence of GD and AIH. The patient was admitted to the Department of Pediatric Endocrinology, presenting with suspected hyperthyroidism. Clinical manifestations included ocular exophthalmos, tachycardia, reduced exercise tolerance, and motor restlessness. Initial laboratory assessments revealed mildly elevated transaminases, prompting further investigation. A primary diagnosis of GD was confirmed by relevant laboratory parameters. Antithyroid drugs (ATD) were administered, resulting in proper control of thyroid dysfunction. However, despite the gradual reduction of ATD, a further increase in hepatic biomarkers was observed and required a comprehensive diagnostic investigation, culminating in a liver biopsy. The findings of the biopsy yielded a definitive diagnosis of AIH.

In pediatric patients presenting with GD-associated liver dysfunction, AIH should be considered as a potential comorbidity, warranting vigilance in patients with hyperthyroidism and elevated transaminase levels.