Duong Nikki, Lee Alice, Lewis James
Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC, USA.
BMJ Case Rep. 2018 Jan 23;2018:bcr-2017-222373. doi: 10.1136/bcr-2017-222373.
The effects of hypothyroidism on the liver are not well understood. A 77-year-old woman with Hashimoto's thyroiditis had stopped taking levothyroxine on her own for 6 months. Her thyroid stimulating hormone (TSH) level was consistent with severe hypothyroidism. She resumed thyroid replacement therapy. The following month, her liver function tests were significantly elevated. Seven weeks after resumption of therapy, her TSH and liver tests had returned to normal. We attribute the mixed hepatocellular injury to hypothyroidism that resolved on correction of the hypothyroid state. This case reminds us that thyroid disease should be considered when evaluating acute liver injury.
甲状腺功能减退对肝脏的影响尚未完全明确。一名77岁患有桥本甲状腺炎的女性自行停用左甲状腺素6个月。其促甲状腺激素（TSH）水平符合严重甲状腺功能减退。她恢复了甲状腺替代治疗。次月，她的肝功能检查结果显著升高。恢复治疗7周后，她的TSH和肝功能检查恢复正常。我们将这种混合性肝细胞损伤归因于甲状腺功能减退，甲状腺功能减退状态纠正后损伤得以缓解。该病例提醒我们，在评估急性肝损伤时应考虑甲状腺疾病。
