Endocrine Abstracts

Introduction: Hyperthyroidism in pregnancy is a common condition representing two different conditions: transient hyperthyroidism of pregnancy and true hyperthyroidism. It is accompanied by liver enzyme disturbances without any other obvious cause.

Objective of the study: To evaluate the prevalence of acute hepatitis associated with hyperthyroidism.

Matherials and methods: Prospective study conducted at the endocrinology and diabetology department of the CHU Casablanca including 42 patients with hyperthyroidism and acute pancreatitis complicated by hyperperemesis gravidarum

Results: The results showed a mean age of 26 years, with a mean gestational age of 11 days after birth, with no personal history of thyroid disease, the predominant clinical reason was vomiting in pregnancy, which was present in all patients. Biologically: The mean TSHus was 0.05 mIU/l, with a mean T4L of 26 ng/l and a mean T3l of 8 ng/l, with a hepatic cytolysis with an average ASAT of 111 IU/l and ALAT of 173 IU/l, a mean lipasemia of 208 IU/l, the abdominal ultrasound was without any particularities and negative hepatic serologies. Therapeutically, the patients were put on synthetic antithyroid drugs with a betablocker and digestive rest with parenteral nutrition. A normalization of the hepatic balance was observed in 87% of the patients after correction of the thyroid balance.

Conclusion: Thyrotoxic hepatitis is retained in front of a disturbed hepatic balance in the context of thyrotoxicosis after having eliminated any other cause in particular viral, autoimmune or drug-induced hepatitis. Hyperthyroidism, whatever its variant, remains a possible cause of hepatitis during pregnancy.