Thyrotoxicosis hepatitis: a case report

Abnormal liver function in thyroid disorders may be secondary to thyrotoxic osis or to autoimmune injury to the liver. We report the case of a 36-year- old female who developed jaundice and pruritus with mild cholestasis and mo derately elevated transaminase levels. The diagnosis of Graves' disease was made shortly thereafter. Laboratory findings were : alanine and aspartate aminotransferase 219 (IU/I (N 9-50) and 102 IU/I (N : 10- 15) respectively, alkaline phosphatase 336 IU/I (N 40-135), bilirubin 24 mu mol/l (N : 2-23) , and gamma-glutamyl transpeptidase 232 IU/I (N : 9-43). Abdominal ultrasonography showed normal bile ducts; echocardiography ruled out heart failure; viral and autoimmune markers for hepatitis and cirrhosis were negative. Percutaneous liver biopsy showed moderate intrahepatic stea tosis, anisokaryosis, lymphocyte infiltration in the portal areas, and Kupf fer cell hyperplasia. outcome was favorable after seven months of iodine th erapy, confirming the diagnosis of thyrotoxicosis hepatitis.