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Case Report



Hyperthyroidism induced reversible hepatotoxicity a case report and brief review

Nikhil Anil Nadkharni, Ibrahim Masoodi, Ali Al Ahmari, Nisar ul Hassan Malik.




Abstract
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The patients presenting with high liver enzymes have multiple etiologies ranging from hepatotoxic viruses, drugs, and various toxins. While viral hepatitis continues to be the leading cause of elevated liver enzymes, other metabolic and endocrine disorders also lead to elevated liver enzymes in a given patient. There is a paucity of data regarding hyperthyroidism and the high liver enzymes. We present the clinical scenario in a young male who presented with jaundice without viral prodrome or offending drug intake. The patient had no high-risk behavior, and on evaluation, he had negative viral serologies. Autoimmune profile was negative as well. The physical examination was suggestive of irregular pulse and normal blood pressure. On further evaluation hyperthyroidism was unraveled. Following treatment with antithyroid medication, the liver enzymes in the index case settled, and he had full clinical recovery, explaining the cause and effect relationship. Report on this case and brief literature review is presented. A good clinical examination often is a lead to the cause of disease and in a Jaundiced patient, hyperthyroidism can be one of the causes of high liver enzymes which must be ruled out in a given setting.

Key words: Hyperthyroidism; Elevated Liver Enzymes; Anti-thyroid Medication; Clinical Examination Clues






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