A Case of Autoimmune Hepatitis Combined with Graves' Disease.
- Author:
Jong Hyun JHEE
1
;
Hyun Ju KIM
;
Wonseok KANG
;
Sewha KIM
;
Do Young KIM
Author Information
- Publication Type:Case Reports
- Keywords: Autoimmune hepatitis; Graves disease; Steroid
- MeSH: Adult; Alanine Transaminase/analysis; Antibodies, Antinuclear/blood; Aspartate Aminotransferases/analysis; Bilirubin/blood; Female; Graves Disease/complications/*diagnosis/drug therapy; Hepatitis, Autoimmune/complications/*diagnosis/drug therapy; Humans; Immunoglobulins, Thyroid-Stimulating/blood; Liver/enzymology/metabolism/pathology; Prednisolone/therapeutic use; Steroids/therapeutic use; Thyrotropin/blood
- From:The Korean Journal of Gastroenterology 2015;65(1):48-51
- CountryRepublic of Korea
- Language:English
- Abstract: A 25-year-old woman presented with jaundice, palpitation, and weight loss of 5 kg during a period of 2 weeks. Laboratory tests showed elevated levels of liver enzymes (AST 1,282 IU/L, ALT 1,119 IU/L) and total bilirubin (6.4 mg/dL); negative for hepatitis virus infection; elevated serum levels of triiodothyronine (T3, 3.60 ng/dL), free thyroxine (fT4, 3.82 ng/dL), and lowered serum level of thyroid stimulating hormone (TSH, <0.025 microIU/mL); and positive for thyroid stimulating antibody and anti-mitochondrial antibody (AMA). The liver biopsy findings were consistent with autoimmune hepatitis (AIH). Accordingly, oral steroid therapy was started with 60 mg of prednisolone under the impression of AIH associated with Graves' disease. After a week of steroid therapy, the clinical manifestation showed significant improvement, with normalization of both liver and thyroid functions. Diagnosis of the liver condition of patients who present with hyperthyroidism and liver dysfunction is important, so that appropriate therapy can be promptly initiated.
