Hypothyroidism as a Mimic of Liver Failure in a Patient with Cirrhosis
Authors: Raed N. Khairy, Kevin D. Mullen
Journal: Annals of Internal Medicine (2007)

Letters20 February 2007Hypothyroidism as a Mimic of Liver Failure in a Patient with CirrhosisRaed N. Khairy, MD and Kevin D. Mullen, MDRaed N. Khairy, MDFrom University of Michigan Health System, Ann Arbor, Michigan, and Case Western Reserve University and MetroHealth Medical Center, Cleveland, Ohio.Search for more papers by this author and Kevin D. Mullen, MDFrom University of Michigan Health System, Ann Arbor, Michigan, and Case Western Reserve University and MetroHealth Medical Center, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-4-200702200-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Hypothyroidism is an unusual cause of ascites. Hypothyroidism may also mimic hepatic encephalopathy in patients with cirrhosis. Reversible, hypothyroidism-induced ascites and encephalopathy simulating liver failure in a patient with cirrhosis awaiting liver transplantation has not been reported.Objective: To describe the resolution of intractable ascites and encephalopathy with treatment of hypothyroidism in a patient with cirrhosis awaiting transplantation.Case Report: A 40-year-old woman with cirrhosis secondary to chronic hepatitis C virus infection had intractable ascites and encephalopathy. She was listed for liver transplantation at another institution. She presented for a second opinion to determine whether additional evaluation and treatment ...References1. Yamamoto T, Takeuchi K, Okuda C, Nagashima N, Honjo H, Sakurai N, et al. Symptomatic hypothyroidism in decompensated liver cirrhosis [Letter]. J Clin Gastroenterol. 2001;33:172-3. [PMID: 11468452] CrossrefMedlineGoogle Scholar2. Hitoshi S, Terao Y, Sakuta M. Portal-systemic encephalopathy and hypothalamic hypothyroidism: effect of thyroid hormone on ammonia metabolism. Intern Med. 1993;32:655-8. [PMID: 8312666] CrossrefMedlineGoogle Scholar3. Thobe N, Pilger P, Jones MP. Primary hypothyroidism masquerading as hepatic encephalopathy: case report and review of the literature. Postgrad Med J. 2000;76:424-6. [PMID: 10878207] CrossrefMedlineGoogle Scholar4. Ji JS, Chae HS, Cho YS, Kim HK, Kim SS, Kim CW, et al. Myxedema ascites: case report and literature review. J Korean Med Sci. 2006;21:761-4. [PMID: 16891828] CrossrefMedlineGoogle Scholar5. de Castro F, Bonacini M, Walden JM, Schubert TT. Myxedema ascites. Report of two cases and review of the literature. J Clin Gastroenterol. 1991;13:411-4. [PMID: 1918846] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Michigan Health System, Ann Arbor, Michigan, and Case Western Reserve University and MetroHealth Medical Center, Cleveland, Ohio.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe interplay between thyroid and liver: implications for clinical practiceCase of acute mixed liver injury due to hypothyroidismHepatic Manifestations of Systemic DisordersRefractory hepatic encephalopathy in a patient with hypothyroidism: Another element in ammonia metabolismHepatic Manifestations of Systemic DiseasesHypothyroidism Enhanced Portal Hypertension in a Patient with Alcoholic Liver Cirrhosis, Resulting in the Development of AscitesHepatic EncephalopathyHepatic Manifestations of Systemic DisordersHepatic Manifestations of Systemic Diseases 20 February 2007Volume 146, Issue 4Page: 315-316KeywordsAlbuminsAscitesBrain diseasesCirrhosisHepatitis CHypothyroidismLiverLiver transplantationThyroxineTransplantation ePublished: 20 February 2007 Issue Published: 20 February 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...