亚临床和显性甲状腺功能亢进症中的肝内胆汁淤积：两例报告
Intrahepatic cholestasis in subclinical and overt hyperthyroidism: two case reports.
作者信息
Soylu Aliye, Taskale Mustafa Gurkan, Ciltas Aydin, Kalayci Mustafa, Kumbasar A Baki
机构信息
Department of Gastroenterology, Dr Sadi Konuk Research Hospital, Istanbul, Turkey.
出版信息
J Med Case Rep. 2008 Apr 21;2:116. doi: 10.1186/1752-1947-2-116.
INTRODUCTION
Non-specific abnormalities in liver function tests might accompany the clinical course of hyperthyroidism. Hyperthyroidism can cause the elevation of hepatic enzymes and bilirubin. Jaundice is rare in overt hyperthyroidism, especially in subclinical hyperthyroidism. On the other hand, the use of anti-thyroid drugs has rarely been associated with toxic hepatitis and cholestatic jaundice.
CASE PRESENTATION
Here we present two cases of cholestasis that accompanied two distinct forms of clinical hyperthyroidism. The first patient had a clinical presentation of severe cholestasis in the absence of congestive failure related to hyperthyroidism. The second case had developed intrahepatic cholestasis in the presence of subclinical hyperthyroidism, and improved with rifampicin treatment.
CONCLUSION
Hyperthyroidism should be a consideration in non-specific liver dysfunction.
引言
肝功能检查中的非特异性异常可能伴随甲状腺功能亢进症的临床病程。甲状腺功能亢进症可导致肝酶和胆红素升高。黄疸在显性甲状腺功能亢进症中罕见，尤其是在亚临床甲状腺功能亢进症中。另一方面，抗甲状腺药物的使用很少与中毒性肝炎和胆汁淤积性黄疸相关。
病例介绍
在此，我们报告两例胆汁淤积症病例，它们分别伴随两种不同形式的临床甲状腺功能亢进症。首例患者临床表现为严重胆汁淤积，且不存在与甲状腺功能亢进症相关的充血性心力衰竭。第二例患者在亚临床甲状腺功能亢进症状态下发生了肝内胆汁淤积，并通过利福平治疗而好转。
结论
对于非特异性肝功能障碍，应考虑甲状腺功能亢进症。
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