Clinical Analysis Of Hyperthyroidism With Liver Damage

For patients with hyperthyroidism which is accompanied with liver function damage, especially hepatitis gravis, doctors may have therapeautic difficulty: anti-hyperthyroidism drug therapy may induce liver damage, but if not treating hyperthyroidism, because excessive catabolism, liver cells can not get enough nutrients, so liver function recovery slowed down.objective: To explore the pathogenesis, clinical features and treatment of hyperthyroidism with Liver function damage, Hepatitis gravis(Hepatic failure).Method: Our investigation included 32 patients with hyperthyroidism accompanied with Liver function damage and 13 patients with hyperthyroidism accompanied with Hepatitis gravis (Hepatic failure). Retrospective studywas used to observe and analyse their clinical forms, structures of etiology, clinical situation and therapeutic efficacy. The data were analysed statisticly by using paired-samples T test and Chi-square. Results:1. Significant difference between the male and female group of hyperthyroidism with Liver function damage was observed, more common in women, with a peak age incidence 14 to 64 years old(P < 0.05).2. All the patients with hyperthyroidism accompanied with liverfunction damage had hepatitis symptoms and signs: 64.4%(29/45) had hepatitis symptoms and signs only; 35.6%(16/45) had both symptoms and signs of hepatitis and hyperthyroidism. Patients who had only symptoms and signs of hyperthyroidismand patients who had neither symptom ofhyperthyroidism norhepatitis symptom were not included in this study. 38 patients were diagnosed with viral hepatitis, 28 with hepatitis B, 4 with hepatotoxicity associated with Antithyroid drugs. Only one patient' hepatitis was induced by hyperthyroidism.3. A significantly higher survival proportion (P < 0.05) of patientstreaed with Antithyroid and liver protecting compared to patients with liver protecting only in patients of hyperthyroidism with liver function lesion. And there are no differences between antithyroid plus liver protecting group and liver protecting group of hyperthyroidism with Hepatitis gravis.4. Treatment with antithyroid was benificial to reduce the ALT & TBILlevel in patients with hyperthyroidism accompanied with liver function damage (P < 0.05) . Treatment with antithyroid was benificial to reduce the ALT level in patients with hyperthyroidism accompanied with Hepatitis gravis also (P < 0.05) , but without effect to reduce the TBIL level in patients with hyperthyroidism accompany with Hepatitis gravis (P> 0.05) .Conclusion: Hyperthyroidism with Liver function damage is more common in women, With a peak age incidence at 14 to 64 years old. Majority of the patients had viral hepatitis, the most is hepatitis B. The patients may have symptoms of both hyperthyroidism and hepatitis, but the symptoms of hyperthyroidism may be masked by symptoms of hepatitis. These patients' hepatitis may be induced by virus, the drugs of anti-hyperthyroidism, and may be caused by hyperthyroidism itself also. There was no much difficulties to make diagnosis of these disease. The prognosis was good when treatment of antithyroid and liver protecting had been used at the same time. But in patients with hyperthyroidism accompanied with Hepatitisgravis(Hepatic failure), liver function had been damaged heavily, and obvious contradiction of treatment is present. Hepatic failure and hyperthyroidism must been treated effectively at the same time. A patient was treated with I131 instead of toxic drugs of anti-hyperthyroidism, and recovered soon. The treatment with I131 may have quite good effect.