Gökhan DİNDAR, Mesut SEZİKLİ, Emre DÖNMEZ

Ciddi bilirübin yüksekliği ile seyreden hipotiroidi olgusu

Hipotiroidi karaciğer üzerine etkisi rastlantısal karaciğer enzim yüksekliklerinden batında asite kadar değişen klinik spektrum içerebilir. Kolestaz ise çoğunlukla hipertiroidide gözlenmekle birlikte her iki klinik durumda izlenebilir. Sunduğumuz hasta endoskopik retrograd kolanjiopankreatografi amaçlı yönlendirilen fakat takiplerinde intrahepatik kolestaz saptanan ve hipotiroidi tedavisi ile tamamen düzelen bir vaka idi. Literatürde ciddi bilirübin yükseklikleri tiroid hastalıklarında nadiren izlenir. Genellikle de hipertiroidide eşlik eder. Hipotiroidide ılımlı enzim yüksekliği ve bilirübin yüksekliği saptansa da bizim vakamızda olduğu gibi 20’li değerlerde bilirübin yüksekliğini literatüre ilk defa sunuyoruz.

Anahtar Kelimeler:

Hipotiroidi, hiperbilirübinemi

A case with severe hyperbilirubinemia due to hypothyroidism

Hypothyroidism has diverse effects on the liver, which may manifest themselves in various clinical forms from incidentally elevated liver function tests to ascites. Cholestasis is generally seen in hyperthyroidism and, in rare cases, along with hypothyroidism. We present a case who was referred to us for endoscopic retrograde cholangiopancreatography due to cholestasis. Intrahepatic cholestasis was revealed during follow-up and improved with treatment for hypothyroidism. We rarely encounter severely elevated serum bilirubin levels in patients with hypothyroidism in the literature. In patients with severe hypothyroidism, mild to moderate abnormal liver tests and elevated bilirubin may be seen, but our case had very high bilirubin levels compared with previously presented patients.

Keywords:

Hypothyroidism, hyperbilirubinemia,

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