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Open Access Case report

Cholestatic hepatic injury due to a thyroid storm: a case report from a resource limited setting

Davis Kibirige13*, Daniel Sekikubo Kiggundu2, Richard Sanya2 and Edrisa Mutebi2

Author Affiliations

1 Department of Medicine, Makerere University College of Health Sciences and Emergency Medicine unit, Mulago national referral and teaching hospital, Kampala, Uganda

2 Department of Medicine, Makerere University College of Health Sciences and Endocrine unit, Mulago national referral and teaching hospital, Kampala, Uganda

3 Department of Medicine, Makerere University College of Health Sciences, P.O.BOX 7062, Kampala, Uganda

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Thyroid Research 2012, 5:6  doi:10.1186/1756-6614-5-6

Published: 28 July 2012

Abstract

Introduction

Thyroid storm is an endocrinological emergency caused by an exacerbation of the hyperthyroid state and is characterized by multi organ dysfunction. Liver dysfunction or injury predominantly of a cholestatic type is one of the atypical manifestations of thyroid storm and has been previously described in literature. However, there have been few published case reports among African patients and from resource limited settings.

Case report

We report a case of a 21 year old Ugandan female patient who presented with a thyroid storm due to untreated Graves’ disease complicated by cholestatic hepatic injury, congestive heart failure and acute kidney injury.

Conclusion

This case highlights the varied multi organ dysfunctions seen in a patient with thyroid storm with emphasis on liver injury mainly to increase awareness among clinicians in resource limited settings. Mechanisms of liver injury due to thyroid storm or hyperthyroidism are discussed in the literature review.

Keywords:
Thyroid storm; Cholestatic hepatic injury; Cholestasis