Akande T O, Balogun W O
Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Afr Health Sci. 2013 Sep;13(3):853-6. doi: 10.4314/ahs.v13i3.48.
Jaundice and hepatic dysfunction have been reported in patients with thyrotoxicosis and could be due to different mechanisms.
To describe three cases of jaundice occurring in patients with thyrotoxicosis and to illustrate the importance of early institution of thionamides when indicated.
We present the clinical and laboratory features of three patients presenting within a year with thyrotoxicosis and jaundice and whose clinical conditions improved remarkably following treatment with thionamides. In addition, current literature on the subject is reviewed and summarised.
The three patients presented with goitre and jaundice. None of the patients had received blood products, undergone scarification markings or experienced any previous episode of jaundice. Thyroid function tests in the three patients were consistent with a diagnosis of thyrotoxicosis. Liver function tests showed elevated bilirubin and transaminases. All patients improved remarkably following treatment with thionamides.
It is important to rule out thyrotoxicosis in patients with jaundice of unknown cause and consider early use of thionamides for treatment of the thyrotoxicosis, if confirmed.
甲状腺毒症患者中曾有黄疸和肝功能障碍的报道，其原因可能各不相同。
描述3例甲状腺毒症患者出现黄疸的情况，并说明在有指征时尽早使用硫代酰胺类药物的重要性。
我们呈现了3例在1年内出现甲状腺毒症和黄疸的患者的临床及实验室特征，这些患者在接受硫代酰胺类药物治疗后临床状况显著改善。此外，对该主题的现有文献进行了回顾和总结。
这3例患者均表现为甲状腺肿大和黄疸。所有患者均未接受过血液制品输注、有划痕标记或既往有黄疸病史。3例患者的甲状腺功能检查结果均符合甲状腺毒症的诊断。肝功能检查显示胆红素和转氨酶升高。所有患者在接受硫代酰胺类药物治疗后均显著好转。
对于病因不明的黄疸患者，排除甲状腺毒症很重要，若确诊为甲状腺毒症，应考虑尽早使用硫代酰胺类药物进行治疗。
