Article Text

Case of acute mixed liver injury due to hypothyroidism
  1. Nikki Duong,
  2. Alice Lee,
  3. James Lewis
  1. Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
  1. Correspondence to Dr. Nikki Duong, nduong91{at}


The effects of hypothyroidism on the liver are not well understood. A 77-year-old woman with Hashimoto’s thyroiditis had stopped taking levothyroxine on her own for 6 months. Her thyroid stimulating hormone (TSH) level was consistent with severe hypothyroidism. She resumed thyroid replacement therapy. The following month, her liver function tests were significantly elevated. Seven weeks after resumption of therapy, her TSH and liver tests had returned to normal. We attribute the mixed hepatocellular injury to hypothyroidism that resolved on correction of the hypothyroid state. This case reminds us that thyroid disease should be considered when evaluating acute liver injury.

  • hepatitis other
  • general practice / family medicine

Statistics from


  • Contributors ND: contribution to conception of work, analysis of data; drafted the work. AL: drafted the work. JL: final approval of the version published; drafting the work or revising it critically for important intellectual content. All authors: agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.