ECE2018 Poster Presentations: Thyroid Clinical case reports - Thyroid/Others (21 abstracts)
Thyrotoxic hepatitis
Lamia Gargouri 1 , Faten Hadjkacem 2 , Dorra Ghorbel 2 , Faiza Safi 1 , Manel Hsairi 1 , Mohamed Abid 2 & Abdelmajid Mahfoudh 1
1Pediatrics Department, Emergency and Intensive Care Unit Service, CHU Hedi Chaker, Sfax, Tunisia; 2Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia.
Introduction: Liver abnormalities are rarely observed in thyrotoxicosis. Diagnosis should be considered only after outruling other possibilities of hepathic pathology, especially autoimmune disaese. We report the case of a 6-year-old girl with Graves’ disease who presented a liver dysfuntion.
Case report: A 6-year-old girl with a history of Graves’ disease diagnosed and treated 15 days before, was admitted for jaundice and pruritus. The interrogation finds the notion of dark urine and partially discolored stool. On physical examination, there was significant jaundice and an hepatomegaly. Laboratory exploration showed an elevated serum level of Aspartate aminotransferase at 53 IU/l, alanine aminotransferase at 68 IU/l, gamma-glutamyltransferase at 16 IU/l, alkaline phosphatase at 959 IU/l and total bilirubinemia at 48 mmol/l. Abdominal ultrasound revealed hepatomegaly with a hetero-micronodular appearance. Cholangi-MRI was normal. After excluding other etiologies for her liver injury (Obstacles to the bile ducts, viral or autoimmune hepatitis and sclerosing cholangitis) she was treated with antithyroid medications (thiamazole (thyrosol®)).The thyroid status was corrected and normalization of liver tests was observed after one month. The diagnosis of “thyrotoxic hepatitis” has been retained.
Conclusion: Hépatic manifestations of hyperthyroidism are both polymorphic and non-specific. It is essential to know how to interpret the liver manifestations that occur during the follow-up of hyperthyroidism. Although the mechanism is not completely understood, antithyroid drugs are crucial in this life-threatening hepatitis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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