Thyrotoxicosis Associated with Cholestatic Jaundice Treated with Therapeutic Plasma ExchangeÃ¢ÂÂCase ReportIrfan Ahmeti1,5*, Viktorija Chalovska2,5, Nevena Manevska3,5, Pavlina Dzekova-Vidimliski4,5, Vladimir Avramoski2,5 and Daniela Pop Gjorceva3,5
- *Corresponding Author:
- Irfan Ahmeti, MD
University Clinic of Endocrinology
Diabetes and Metabolism, Skopje
Tel: +389 70239607
E-mail: [email protected]
Received date: February 18, 2017; Accepted date: March 15, 2017; Published date: March 21, 2017
Citation: Ahmeti I, Chalovska V, Manevska N, Dzekova- Vidimliski P, Avramoski V et al. (2017) Thyrotoxicosis Associated with Cholestatic Jaundice Treated with Therapeutic Plasma Exchange–Case Report. Thyroid Disorders Ther 6:211. doi: 10.4172/2167-7948.1000211
Copyright: © 2017 Ahmeti I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Thyroid disorders, especially thyrotoxicosis, are commonly associated with hepatic dysfunction, but cholestasis is rarely reported. Heart failure, infection, weight loss may play role in the pathogenesis of cholestasis. Cholestasis could be worsened by treatment of hyperthyroidism using Thiamazole, but cholestasis in undiagnosed thyrotoxicosis is uncommon. We present 23 year old female with jaundice, goiter, palpitation and confirmed thyrotoxicosis associated with hepatomegaly, hepatocelluar damage and cholestasis. Liver biopsy excluded the suspicion of autoimmune hepatitis. Therapeutic plasma exchange was performed 5 days after starting the treatment with thyroid supressive therapy, and hepatoprotective therapy due to progressive increase of serum levels of bilirubin (conjugated/direct) and liver enzymes. The patient treatment continued with low doses of thyroid suppressive therapy. Patient achieved euthyroid state after 2 months with normalization of the serum levels of liver enzymes and bilirubin. The final treatment option for our patient was surgical total thyroidectomy.