Journal of the Chinese Medical Association
Volume 73, Issue 1 , Pages 44-46, January 2010

Hepatic Failure Resulting From Thyroid Storm With Normal Serum Thyroxine and Triiodothyronine Concentrations

  • Chin-Sung Kuo

      Affiliations

    • Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Wen-Ya Ma

      Affiliations

    • Cardinal Tien Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Yi-Chun Lin

      Affiliations

    • Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Hong-Da Lin

      Affiliations

    • Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Hong-Da Lin, Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 15 April 2009; accepted 25 September 2009.

Article Outline

A 63-year-old male presented with productive cough, fever, palpitation, shortness of breath, and mental confusion. Fulminant hepatic failure occurred with high aminotransferase and severe jaundice. Thyroid function tests showed thyroid-stimulating hormone level of 0.7 μU/mL (normal range, < 6.2 μU/mL), with normal serum thyroxine and triiodothyronine levels. He died on post-admission day 5. Autopsy revealed diffuse hyperplasia of the thyroid gland, centrilobular necrosis of the liver, and congestion of the gastrointestinal tract, spleen, and adrenal glands. These pathological findings were compatible with decompensated hyperthyroidism. Thyroid storm may present with normal serum triiodothyronine, thyroxine, and hepatic failure. Such presentation is rare.

Key Words:  hepatic failure , hyperthyroidism , thyroid crisis

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PII: S1726-4901(10)70021-6

doi:10.1016/S1726-4901(10)70021-6

Journal of the Chinese Medical Association
Volume 73, Issue 1 , Pages 44-46, January 2010

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