Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge
Hepatic dysfunction in a patient with thyrotoxicosis may result from hyperthyroidism per se, as a side effect of antithyroid drugs, and causes unrelated to hyperthyroidism which sometimes causes diagnostic and therapeutic difficulties. A young female patient was admitted to our hospital with symptom...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/790458 |
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| author | Ashok Krishna Bhuyan Dipti Sarma Uma Kaimal Saikia Bipul Kumar Choudhury |
| author_facet | Ashok Krishna Bhuyan Dipti Sarma Uma Kaimal Saikia Bipul Kumar Choudhury |
| author_sort | Ashok Krishna Bhuyan |
| collection | DOAJ |
| description | Hepatic dysfunction in a patient with thyrotoxicosis may result from hyperthyroidism per se, as a side effect of antithyroid drugs, and causes unrelated to hyperthyroidism which sometimes causes diagnostic and therapeutic difficulties. A young female patient was admitted to our hospital with symptoms of thyrotoxicosis, diffuse goiter and ophthalmopathy along with cholestatic pattern of jaundice, and proximal muscle weakness. She was treated with propylthiouracil with gradual recovery. She was continuing her antithyroid medication with regular follow-up. The patient was readmitted a few months later with worsening thyrotoxicosis, proximal muscle weakness, fever, and a hepatocellular pattern of jaundice with sepsis. Propylthiouracil was stopped and lithium along with steroid coverage was given to control her thyrotoxicosis which was later changed to methimazole. Broad spectrum antibiotic therapy was also started but without any response. During her hospital stay, the patient also developed a flaccid paraplegia resembling Guillain-Barre syndrome. IV steroid was started for the neuropathy but meanwhile the patient succumbed to her illness. So in centers where facility for radioiodine therapy is not readily available, some definite well-tested protocols should be formulated to address such common but complicated clinical situations. |
| format | Article |
| id | doaj-art-c538c10aefca49039ebcf65135e0c960 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-c538c10aefca49039ebcf65135e0c9602025-02-03T01:22:19ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/790458790458Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic ChallengeAshok Krishna Bhuyan0Dipti Sarma1Uma Kaimal Saikia2Bipul Kumar Choudhury3Gauhati Medical College, Guwahati 781032, IndiaGauhati Medical College, Guwahati 781032, IndiaGauhati Medical College, Guwahati 781032, IndiaGauhati Medical College, Guwahati 781032, IndiaHepatic dysfunction in a patient with thyrotoxicosis may result from hyperthyroidism per se, as a side effect of antithyroid drugs, and causes unrelated to hyperthyroidism which sometimes causes diagnostic and therapeutic difficulties. A young female patient was admitted to our hospital with symptoms of thyrotoxicosis, diffuse goiter and ophthalmopathy along with cholestatic pattern of jaundice, and proximal muscle weakness. She was treated with propylthiouracil with gradual recovery. She was continuing her antithyroid medication with regular follow-up. The patient was readmitted a few months later with worsening thyrotoxicosis, proximal muscle weakness, fever, and a hepatocellular pattern of jaundice with sepsis. Propylthiouracil was stopped and lithium along with steroid coverage was given to control her thyrotoxicosis which was later changed to methimazole. Broad spectrum antibiotic therapy was also started but without any response. During her hospital stay, the patient also developed a flaccid paraplegia resembling Guillain-Barre syndrome. IV steroid was started for the neuropathy but meanwhile the patient succumbed to her illness. So in centers where facility for radioiodine therapy is not readily available, some definite well-tested protocols should be formulated to address such common but complicated clinical situations.http://dx.doi.org/10.1155/2014/790458 |
| spellingShingle | Ashok Krishna Bhuyan Dipti Sarma Uma Kaimal Saikia Bipul Kumar Choudhury Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge Case Reports in Medicine |
| title | Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge |
| title_full | Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge |
| title_fullStr | Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge |
| title_full_unstemmed | Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge |
| title_short | Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge |
| title_sort | grave s disease with severe hepatic dysfunction a diagnostic and therapeutic challenge |
| url | http://dx.doi.org/10.1155/2014/790458 |
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