Primary biliary cirrhosis associated with painless thyroiditis

A case of anti-mitochondrial antibody (AMA)-negative primary biliary cirrho sis (PBC) associated with painless thyroiditis is reported in a 47-year-old woman who diagnosed as PBC based on her elevated serum gamma-glutamyl tran speptidase and immunoglobulin M levels, as well as histological findings of destroyed bile ducts surrounded by mononuclear infiltrates in the biopsied liver. She was negative for AMA and had a depressed level of thyroid-stimu lating hormone accompanied by increased free thyrosine, thyroxine and triio dothyronine levels and low titers of anti-microsomal and anti-thyroid perox idase antibodies. Her thyroid disorder corresponded with painless thyroidit is. An association between PBC and hyperthyroidism is rare, Furthermore, an association between AMA-negative PBC and hyperthyroidism due to painless t hyroiditis has not previously been reported.