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Home > Archives > Volume 20, No 8 (2022) > Article

DOI: 10.14704/nq.2022.20.8.NQ44723

A Review of Thyroid dysfunction and Cirrhosis

Ahmed Mohamed Esmat, Waleed Ahmady Abd Eldaym, Ahmed lotfy Sharaf

Abstract

Liver cirrhosis is one of the most common diseases affecting Egyptian population and viral hepatitis is the most common etiological factor causing hepatic cirrhosis. Among the hepatitis viruses, hepatitis C virus appears to be a common cause of liver cirrhosis. Cirrhosis affects 2.8 million people and was the cause of death in 1.3 million in 2015. Clinically, cirrhosis may be compensated or decompensated, depending upon the absence or presence of the complications of cirrhosis. Patients with decompensated cirrhosis usually present to different medical wards with moderate to severe ascites, variceal bleeding, hepatic encephalopathy, hepatorenal or hepatopulmonary syndrome or with hepatocellular carcinoma. Cirrhosis results from different mechanisms of liver injury that lead to necroinflammation and fibrogenesis; histologically, it is characterized by diffuse nodular regeneration surrounded by dense fibrotic septa with subsequent parenchymal extinction and collapse of liver structures. Approximately 60% of patients with cirrhosis will develop ascites within 10 years after diagnosis of this disease. Refractory ascites, which develops in 5% - 10% of all patients with cirrhotic ascites, has a high mortality rate. A complex relationship exists between thyroid and liver in health and disease. Liver plays an essential physiological role in thyroid hormone activation and inactivation, transport, and metabolism. Alternately, activities of hepatocytes and hepatic metabolism are affected by thyroid hormones. Serum liver enzyme abnormalities observed in hypothyroidism may be related to impaired lipid metabolism, hepatic steatosis or hypothyroidism-induced myopathy. Severe hypothyroidism may have biochemical and clinical features such as hyperammonemia and ascites, impersonating those of liver failure. Liver function tests are frequently abnormal also in hyperthyroidism, because of oxidative stress, cholestasis, or enhanced osteoblastic activity.

Keywords

Thyroid dysfunction, Cirrhosis

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