Thyroid Dysfunction in Patients with Liver Cirrhosi

Abstract

Aim: To estimate the prevalence of thyroid dysfunction in patients with liver cirrhosis. Materials and Methods: Early morning fasting serum thyroid stimulating hormone (TSH), serum total free thyroxine (FT4) and free triiodothyronine (FT3) was measured by radioimmunoassays in 111 index patients with liver cirrhosis who did not have history of thyroid diseases. Study period wasoctober 2014 to december 2016. The age of study population was in the range of 25-60 years. Out of 111 patients, 80 were males and 31 were females.Out of 111 patients 64 had ethanol related liver disease, 21 had Hepatitis B positivity, 5 had hepatitis C positivity, 5 had autoimmune hepatitis, 4 had wilson disease and 12 had crytogenic cirrhosis. Out of the 111 patients, 28 belonged CTP A, 53 belonged CTP B and 30 belonged CTP C. Results: Hypothyroidism was seen in 24 out of 111 patients (21.6%). Only serum TSH increase was seen in 12 patients (10.8%) and Serum TSH increase along with FT3 and FT4 decrease in 12 patients out of 111 patients (10.8%). Of the 24 patients having hypothyroidism, 5 belonged to CTP A (out of 28 i.e 17.8%), 11 belonged to CTP B (out of 53 i.e 20.7%), and 8 belonged to CTP C (out of 30 i.e 26.6%).Of the 24 patients having hypothyroidism, 16 (66.6%) were those having ethanol related liver cirrhosis, 4 (16.6%) have Hepatitis B positivity and 4 (16.6%) have other causes of liver cirrhosis. Out of the 64 patients who had ethanol related liver cirrhosis 16 had hypothyroidism (25%) and 4 out of 21 patients having Hepatitis B related liver cirrhosis had hypothyroidism (19%). Conclusion: Abnormalities in circulating thyroid hormone concentrations i.e hypothyroidism is noted especially in those with ethanol related liver cirrhosis and it is associated with more advanced liver disease.