title: Primary biliary cirrhosis associated with Graves' disease in a male patient.
abstract: Primary biliary cirrhosis (PBC), which predominantly affects women, has been associated with various autoimmune diseases. Although hypothyroidism accompanying PBC is well documented, the concomitance of PBC and hyperthyroidism is rare. Herein, we report the case of a 62-year-old man who was diagnosed with PBC several years after the development of Graves' disease. This is the first case of a male patient developing PBC with Graves' disease. Both serum alanine aminotransferase levels and serum thyroid hormone levels were normalized after the administration of thiamazole for Graves' disease. However, the cholestatic liver enzyme abnormalities continued, indicating that the PBC was actualized by the administration of thiamazole. After starting ursodeoxycholic acid treatment, cholestatic liver enzyme abnormalities improved. Taken together, when a cholestatic pattern of liver enzymes is observed during follow-up for Graves' disease, an association between Graves' disease and PBC should be considered as a differential diagnosis.
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan. yusuzuki@iwate-med.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Iwate, 020-8505, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Department of Gastroenterology, Iwate Prefectural Ninohe Hospital, 38-2 Horino Aza Ookawarake, Ninohe, Iwate, 028-6193, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterology, Iwate Prefectural Ninohe Hospital, 38-2 Horino Aza Ookawarake, Ninohe, Iwate, 028-6193, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Koeda
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kakisaka
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takikawa
mesh_terms: D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid
keywords: Autoimmunity; Graves’ disease; Primary biliary cirrhosis