Department of Gastroenterology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
Medicine (Baltimore). 2023 Nov 10;102(45):e35972. doi: 10.1097/MD.0000000000035972.
We present a case of a 43-year-old female patient diagnosed with hyperthyroidism. This study aims to demonstrate the rare association between hyperthyroidism and severe cholestatic jaundice, and the effectiveness of methimazole treatment.
The patient developed severe jaundice, a typically mild symptom in most hyperthyroidism cases.
The severe jaundice was suspected to be a result of cholestasis induced by hyperthyroidism, with other potential causes such as drug-induced or autoimmune liver dysfunction being ruled out.
The patient was effectively treated with methimazole. Outcomes: Treatment with methimazole alleviated the severe cholestatic jaundice and restored normal thyroid function.
The specific mechanism of cholestasis as a secondary complication of hyperthyroidism remains unclear, and there are no specific biochemical markers for cholestasis caused by this hormonal disease. This case underscores the possibility of severe jaundice as a clinical manifestation of hyperthyroidism, and highlights antithyroid drug treatment as an effective strategy for managing severe cholestatic jaundice.
我们报告了一例 43 岁女性甲状腺功能亢进症患者。本研究旨在阐述甲状腺功能亢进症与严重胆汁淤积性黄疸之间罕见的关联，以及甲巯咪唑治疗的效果。
患者出现严重黄疸，这在大多数甲状腺功能亢进症患者中是一种相对较轻的症状。
严重黄疸疑似由甲状腺功能亢进症引起的胆汁淤积所致，已排除其他潜在病因，如药物性或自身免疫性肝损伤。
患者接受甲巯咪唑治疗后症状缓解。
甲巯咪唑治疗缓解严重胆汁淤积性黄疸并恢复正常甲状腺功能。
甲状腺功能亢进症继发胆汁淤积的确切机制尚不清楚，也没有针对这种激素疾病引起的胆汁淤积的特异性生化标志物。该病例强调了严重黄疸作为甲状腺功能亢进症临床表现的可能性，并突出了抗甲状腺药物治疗对严重胆汁淤积性黄疸的有效性。
