Clinical management of hyperthyroidism complicated with liver failure
10.3760/cma.j.cn311282-20220509-00293
- VernacularTitle:甲状腺功能亢进症合并肝衰竭的临诊应对
- Author:
Xiaoyun FENG
1
;
Jingzhu WU
;
Li ZHAO
;
Yijie WU
;
Yongde PENG
;
Fang LIU
;
Yufan WANG
Author Information
1. 上海交通大学医学院附属第一人民医院内分泌科 200080
- Keywords:
Hyperthyroidism;
Liver failure;
Clinical characteristics;
Diagnosis and treatment;
Prognosis
- From:
Chinese Journal of Endocrinology and Metabolism
2023;39(7):611-615
- CountryChina
- Language:Chinese
-
Abstract:
Clinical data from 11 previously diagnosed and treated patients with hyperthyroidism(Graves′ disease) complicated by liver failure were collected. Among them, 4 cases were drug-induced liver injury leading to liver failure, 1 case had a history of schistosomal liver cirrhosis combined with hyperthyroidism, and 6 cases had hyperthyroidism-induced liver injury(HILI) leading to liver failure. During hospitalization, all patients received supportive therapy and symptomatic treatment with β-blockers. Nine patients were treated with glucocorticoids and artificial liver support therapy. Among the 11 patients, 2 died, 8 patients achieved normal thyroid and liver function within 1-12 months after treatment, and 1 patient with liver cirrhosis had stable liver function in the later stage. After improvement in liver function, 7 patients received isotope therapy, 1 patient underwent total thyroidectomy, and 1 patient received medication. These results indicate that the clinical characteristics differ for drug-induced liver injury and HILI-related liver failure. Early initiation of artificial liver support therapy, in addition to β-blockers and glucocorticoids, is important in alleviating thyroid toxicity and liver damage, thus creating an opportunity for subsequent radioactive iodine or surgical treatment.
