title: Cholestatic hepatic injury due to a thyroid storm: a case report from a resource limited setting.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Medicine, Makerere University College of Health Sciences and Emergency Medicine unit, Mulago national referral and teaching hospital, Kampala, Uganda. davouirek@yahoo.co.uk.
authors: Davis
authors: D
authors: Kibirige
authors: Daniel Sekikubo
authors: DS
authors: Kiggundu
authors: Richard
authors: R
authors: Sanya
authors: Edrisa
authors: E
authors: Mutebi