Intrahepatic Cholestasis and Hyperbilirubinemia Induced by Hyperthyroidism: A Case Series
DOI:
https://doi.org/10.52787/agl.v53i2.294Keywords:
Hyperthyroidism, intrahepatic cholestasis, jaundice, thyroid diseases, liver function tests, non-alcoholic fatty liver disease, methimazole, iodineAbstract
Hyperthyroidism is a disorder characterized by excess endogenous production of thyroid hormones. It is common to find alterations in hepatic biochemistry related to this diagnosis. These include elevated alkaline phosphatase, elevated aminotransferases and, to a lesser extent, hyperbilirubinemia, usually mild and asymptomatic. Here we present two cases of severe direct hyperbilirubinemia induced by hyperthyroidism, one of them with associated intrahepatic cholestasis. These are rare but well-known forms of presentation of the disease.
References
-1. Piantanida E, Ippolito S, Gallo D, Masiello E, Premoli P, Cusini C, et al. The interplay between thyroid and liver: implications for clinical practice. Vol. 43, Journal of Endocrinological Investigation. Springer; 2020. p. 885-99.
-2. Habershon S. Exophthalmic goiter, heart disease, jaundice, death. Lancet. 1874;1:510-2.
-3. Huang MJ, Li KL, Wei JS, Wu SS, Fan KD, Liaw YF. Sequential liver and bone biochemical changes in hyperthyroidism: prospective controlled follow-up study. Am J Gastroenterol. 1994 Jul;89(7):1071-6.
-4. Yorke E. Hyperthyroidism and Liver Dysfunction: A Review of a Common Comorbidity. Vol. 15, Clinical Medicine Insights: Endocrinology and Diabetes. SAGE Publications Ltd; 2022.
-5. Soylu A, Taskale M, Ciltas A, Kalayci M, Baki Kumbasar A. Intrahepatic cholestasis in subclinical and overt hyperthyroidism: Two case reports. J Med Case Rep. 2008 Apr 21;2.
-6. Wafa B, Faten H, Mouna E, Fatma M, Mohamed A. Hyperthyroidism and hepatic dysfunction: Report of 17 cases. JGH Open. 2020 Oct 1;4(5):876-9.
-7. Wang R, Tan J, Zhang G, Zheng W, Li C. Risk factors of hepatic dysfunction in patients with Graves’ hyperthyroidism and the efficacy of 131 iodine treatment. Medicine (United States). 2017 Feb 1;96(5).
-8. Zeng B, Yuan L, Chu J, Yang Y, Lin S. Challenges in early identification of causes and treatment of cholestasis in patients with hyperthyroidism: a case report and literature review. Journal of International Medical Research. 2019;48(3).
-9. Abebe A, Eck LM, Holyoak M. Severe cholestatic jaundice associated with Graves’ disease. Clin Case Rep. 2018 Nov 1;6(11):2240-5.
-10. Barra MI, Olmos R, Barrera F, Mosso L, Domínguez JM, Domínguez JM. Cholestasis secondary to hyperthyroidism in Graves’ disease. Report of one case. Vol. 148, CASOS CLÍNICOS Rev Med Chile. 2020.
-11. Ichikawa H, Ebinuma H, Tada S, Ojiro K, Yamagishi Y, Tsukada N, et al. A case of severe cholestatic jaundice with hyperthyroidism successfully treated with methimazole. Clin J Gastroenterol. 2009 Aug;2(4):315-9.
-12. Opoku-Akyeampong NAAS, Agyei-Nkansah A, Yorke E. Liver dysfunction associated with hyperthyroidism: Lessons from 2 Case reports. Clin Case Rep. 2021 Jun 1;9(6).
-13. Aydemir S, Bayraktaroglu T, Demircan N, Sert M, Açikgoz S, Tekin IO, et al. Effect of hyperthyroidism and propylthiouracil treatment on liver biochemical tests. Int J Clin Pract. 2005 Nov;59(11):1304-8.
-14. Haddaden M, Hanna A, Odish F, Husami S, Imam Z, Tahhan M. Cholestatic Hepatitis in Graves’ Disease: A Diagnostic Challenge. ACG Case Rep J. 2021 Jan;8(1):e00526.

Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Juan Pablo Sánchez Garcés, María Clara Ospino Guerra, Jarny José Morales Marenco, Mario Joaquín Moscote Granadillo, Raquel Amira Cano Peñaloza, Carlos Mario Moscote Terán

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.