An autopy case of hyperthyrodism complicated with acute hepatic necrosis

MIYAKE Shu, KOHNO Hiroshi, ARAKI Fumio

doi:10.2957/kanzo.24.62

Thyrotoxic crisis ("crisis") is often fatal in its clinical course once it occurs. Liver injury has been discussed as one of the causes of the "crisis". We report an autopsy case of hyperthyroidism complicated with remarkable acute hepatic necrosis.<BR>A 71-year old female, who was pointed out hyperthyroidism five years ago althougn without treatment, was admitted to our hospital on Jan 4'82 with chief complaint of blurred consciousness level. She caught cold on the day before and took a commercial medicine for herself. She had blurred consciousness level, jaundice, exophthalmos and tachycardia (pulse rate=142) on admission. She had leukocytosis, elevated T3 uptake and liver injury on laboratory examination. She died about 17 hours later despite of the institutions of digitalis, β-blockers, steroid and so on. The autopsy revealed the findings consistent with hyperthyroidism complicated with acute hepatic necrosis. We find some reports on the hepatic changes in hyperthyroidism. Fatty degeneration, central and localized necrosis etc. are reportedly main findings but we can not find a report of hyperthyroidism complicated with prominent hepatic necrosis. The cases of hyperthyroidism with jaundice are said to be often followed by the "crisis", so we must take much care whether jaundice is present or not in these cases.

An autopy case of hyperthyrodism complicated with acute hepatic necrosis

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