title: A case of severe cholestatic jaundice with hyperthyroidism successfully treated with methimazole.
abstract: Liver dysfunction is a common complication observed in patients with hyperthyroidism, however the dysfunction is always mild and obvious jaundice is rarely observed. We present the case of a 43-year-old man who suffered from hyperthyroidism complicated by severe jaundice. The jaundice likely occurred as a secondary consequence of cholestasis due to hyperthyroidism, since other causes such as drug-induced or autoimmune liver dysfunction were ruled out. Treatment with methimazole improved severe cholestatic jaundice in parallel with normalization of thyroid function. The mechanism of cholestasis as a secondary complication of hyperthyroidism has not been uncovered and there is no specific biochemical marker for cholestasis due to this hormonal disease at present. This case serves as a reminder that severe jaundice can be a manifestation of simple hyperthyroidism, and that administration of antithyroid drugs is an effective treatment for severe cholestatic jaundice in such cases.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ichikawa
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ebinuma
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Tada
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ojiro
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamagishi
authors.affiliation: Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.affiliation: Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Hongou
authors.affiliation: Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Funae
authors.affiliation: Division of Diagnostic Pathology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Irie
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. hsaito@sc.itc.keio.ac.jp.
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Saito
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
keywords: Cholestatis; Hyperthyroidism; Jaundice