Download 64 cases of hyperthyroidism in patients with hepatic dysfunction

64 cases of hyperthyroidism in patients with
hepatic dysfunction clinical analysis
Posted:2011-3-8 13:17:00
views:10822
[Keywords:], hyperthyroidism, liver dysfunction
Hyperthyroidism is not uncommon with hepatic dysfunction, hyperthyroidism can
affect the liver, causing liver dysfunction, hepatomegaly and jaundice. In our
hospital from March 2001 to December 2008 hospitalized patients were treated 263
cases of hyperthyroidism, including liver function damage in patients of 64 cases
(24.3%, the Liver after antithyroid therapy treatment significantly improved
symptoms of hyperthyroidism, most of the prognosis is good. is now on its clinical
features are analyzed below.
Clinical data
1. General Information
The group of 64 patients with liver dysfunction in patients with hyperthyroidism with
18 males, accounting for 28.2%, female 46 cases, accounting for 71.8%, duration of
1 month to 20 years, ages 16 to 72 years old, disease duration �� 6 months, 20
patients , accounting for 31.3%, duration> 6 months of the 44 cases, accounting for
68.7%.
2. Diagnostic criteria
All patients are in line with the seventh edition <<within SCIENCES ">
hyperthyroidism diagnostic criteria [1], abnormal liver function standards for total
bilirubin> 20 mmol / L, ALT> 40 IU / L, AST> 40 IU / L, AKP > 121 IU / L, A / G
inversion, there is more than two to liver damage, excluding viral hepatitis and other
liver and gallbladder disorders, drug-induced liver dysfunction.
3. Clinical manifestations
64 cases of hyperthyroidism in patients with hepatic dysfunction, 18 cases showed
weakness, anorexia, nausea, liver damage the liver and other symptoms of
discomfort (28.2%, 40 patients without obvious symptoms of liver damage (62.5%,
6 cases of liver dysfunction severe (9.3%, a marked jaundice, hepatosplenomegaly
and liver function was abnormal.
4. Laboratory
64 patients with hyperthyroidism with patients with impaired liver function were in
the use of antithyroid drugs prior to liver function (detected by automatic
biochemical analyzer, in which 18 patients with elevated ALT (accounting for 25.0%,
AST increased in 12 cases (accounting for 18.7%, ALP increased 42 cases (65.6%),
total bilirubin (TB increased in 20 cases (31.2%, decreased albumin, A / G inversion
in 14 cases (21.8%.
5. Treatment and prognosis
64 cases of hyperthyroidism in patients with liver dysfunction or vitamin herein are
Liver treatment C, B6 and liver protection drugs. Mild abnormal liver function, while
in the Liver with antithyroid drugs, 6 cases of severe liver injury in the use of Liver
review two months after treatment, liver function indices were normal, the use of
antithyroid drugs .64 56 cases of patients treated by the above, relieve symptoms of
hyperthyroidism, repeated after two months with normal liver function .8 patients in
the use of antithyroid drug treatment, abnormal liver function repeatedly in favor of
131I treatment of hyperthyroidism symptoms disappeared.
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Discussion
Clinical hyperthyroidism with hepatic dysfunction are more common, reported in the
literature was 20% to 25% [2], the group rate was 24.3%, to match.
Hyperthyroidism with clinical manifestations of liver dysfunction than most minor,
and hyperthyroid heArt disease, thyrotoxic myopathy, very different eye diseases
[3], impaired liver function in patients with hyperthyroidism with most of the normal
appetite, only a minority of patients showed weakness, anorexia and other
symptoms, which are significantly different hyperthyroidism with viral hepatitis.
Hyperthyroidism with the pathogenesis of liver damage is not very clear, now that
the following factors [4]: �� high metabolic state in hyperthyroidism, increased
oxygen consumption of liver cells has not been a corresponding increase in liver
blood flow, resulting in the relative lack of oxygen condition, cells more vulnerable to
injury, liver injury is more important. �� thyroid hormone has a direct toxic effect
on the liver, thereby increasing the liver damage. �� hyperthyroidism immune
response directly through the body can also cause liver damage. �� catabolic
hyperthyroidism hyperthyroidism, the excessive liver glycogen depletion, excessive
consumption of essential amino acids and vitamins, resulting in liver relative
malnutrition, but also indirectly lead to liver damage occurred. �� hyperthyroidism,
liver injury, the liver synthesis of thyroxine binding globulin (TBG reduced, leading
to increase in free thyroxine and increased liver damage. �� hyperthyroidism
complicated by heArt failure, infection and shock, can lead to liver damage.
hyperthyroidism with normal liver function in patients with good prognosis, this
group of patients with Graves disease control, supported by Liver treatment, liver
function recovery after more than two months, a few obvious hyperthyroidism in
patients with abnormal liver function, can not tolerate antithyroid drugs and
switched to 131I treatment of hyperthyroidism, the condition can basically be
controlled.
[References]
] Zai-Ying Lu, Zhong Nanshan, Journal of. [M]. 7th Edition. Beijing: People's Health
and Birth Press, 2008,719.
[2] Wuzuo Yan, Bing-yuan. Hyperthyroidism induced liver injury [J]. Chinese Journal
of Internal Medicine, 2002,22 (5:311-312.
[3] to pay to stay Jun, Li Shou, Liu, et al. Hyperthyroidism with clinical observation
of liver damage [J]. Misdiagnosis of China, 2007,7 (21) :4994 -4995.
[4] section Min Hong, Chen Guangyuan, Zhang Tong. Hyperthyroidism related to
liver function in patients with factor analysis [J]. Postgraduates of Medicine, 2006,29
(6) :53-54.