Endocrine Abstracts

Introduction: Hyperthyroidism (HT) has been associated with hepatic dysfunction in the presence or absence of congestive heart failure (CHF). Our objective is to study the correlation between the clinical and biological presentation of hepatic abnormalities and the cardiac status.

Patients and methods: This retrospective study included 17 patients hospitalized in the endocrinology department of Hedi Chaker Hospital in Sfax over 20 years (1997–2017). We included patients with untreated and non-iatrogenic hyperthyroidism among whom biochemical findings noted hepatic dysfunction and excluded those with concomitant liver disease. Our patients were divided into two categories: «HT with CHF» and «HT without CHF».

Results: Our population is composed of 10 men and 7 women. Eleven patients manifested CHF. The average age of the two groups was comparable (45 years). Only patients with CHF had on abdominal examination ascites, splenomegaly and hepatomegaly. However, no significant difference in clinical presentation was noted between the two categories. The most frequent hepatic dysfunction was cholestasis in both groups (6/6 vs 9/11; P=0.515). The cytolysis was significatively more observed in the absence of CHF (5/6 vs 2/11; P=0.035). The hepatic dysfunction was severe in two cases, both with CHF. The cardiac failure was mainly global (8/11 cases) with an average left ventricular ejection fraction (LVEF) of 37.7±7.7%. A negative correlation, yet not significant, between LVEF and ALAT was noted (P=0.05).

Conclusion: It seems likely that congestive heart failure is common in this population. There did not appear to be a consistent relationship between the magnitude of hepatic abnormalities and the cardiac status. More studies are needed to further investigate this association.