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Sequential liver and bone biochemical changes in hyperthyroidism: prospective controlled follow-up study

M J Huang1, K L Li, J S Wei

  • 1Division of Endocrinology, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.

The American Journal of Gastroenterology
|July 1, 1994
PubMed
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Hyperthyroidism frequently causes abnormal liver and bone tests, particularly alkaline phosphatase (ALP). While alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) often normalize with propylthiouracil (PTU) treatment, transient hepatotoxicity occurs in a third of patients.

Area of Science:

  • Endocrinology
  • Hepatology
  • Biochemistry

Background:

  • Hyperthyroidism is a complex endocrine disorder with potential systemic effects.
  • Biochemical abnormalities in liver and bone are frequently observed in hyperthyroid patients.
  • Understanding these changes is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the prevalence and temporal changes of liver and bone biochemical abnormalities in hyperthyroidism.
  • To assess the impact of propylthiouracil (PTU) treatment on these biochemical markers.
  • To differentiate between hyperthyroidism-related changes and potential drug-induced liver injury.

Main Methods:

  • A cohort of 95 hyperthyroid patients and 66 euthyroid controls were studied.

Related Experiment Videos

  • Patients received propylthiouracil (PTU) for 5 months with varying dosages.
  • Serum liver enzymes (AST, ALT, ALP, GGT, bilirubin), ALP isoenzymes, and hepatitis markers were analyzed pre- and post-treatment.

    • Main Results:

    • 75.8% of hyperthyroid patients exhibited at least one biochemical abnormality.
    • Elevated ALT, ALP, and GGT were common, with ALP elevation primarily due to bone isoenzyme.
    • While ALT and GGT generally normalized during PTU therapy, one-third experienced transient, asymptomatic ALT elevation, and one patient developed overt hepatitis.

    Conclusions:

    • Hyperthyroidism is frequently associated with biochemical abnormalities, especially elevated ALP, which can cause diagnostic challenges.
    • Bone isoenzyme significantly contributes to total ALP elevation in hyperthyroidism.
    • PTU therapy usually resolves ALT and GGT abnormalities, but transient hepatotoxicity necessitates monitoring, though discontinuation is rarely required unless overt hepatitis occurs.