Severe cholestatic jaundice secondary to hyperthyroidism

Introduction: Hyperthyroidism is a known cause of nonspecific abnormalities in liver biochemitries; most commonly mild elevations in serum bilirubin and liver enzymes. Case Report: A case of severe cholestatic jaundice secondary to Grave’s disease. The patient is a 28­year­old African­American male who presented to the emergency room with chronic diarrhea, weight loss and jaundice. At presentation, his liver enzymes were elevated in a cholestatic pattern and his bilirubin was 21.4 mg/dL. Upon treatment with propranolol and propylthouracil, his diarrhea, pruritus, jaundice, and liver enzymes quickly improved. His bilirubin returned to normal over a period of two months. Conclusion: While severe intrahepatic cholestasis and jaundice due to hyperthyroidism is rare, the diagnosis should be considered in patients presenting with manifestations of liver disease, as appropriate treatment of hyperthyroidism results in resolution of jaundice.