Use of plasmapheresis in the treatment of severe intrahepatic cholestasis associated with Graves' disease: a case report
DOI:
https://doi.org/10.59093/27112330.74Keywords:
jaundice, cholestasis, Graves' disease, hyperthyroidism, plasmapheresis.Abstract
Thyrotoxicosis is the clinical manifestation of excessive thyroid hormone release, whether or not associated with autonomous glandular function; in this first scenario, it is specifically termed hyperthyroidism. The main aetiologies are Graves' disease (GD), toxic adenoma, toxic multinodular goiter and the group of thyroiditis, predominantly acute and subacute forms. GD is the most common form of hyperthyroidism, accounting for 60% to 80% of cases, with a higher incidence among people aged 40-60 years. Liver involvement has been reported in 45-90% of patients with hyperthyroidism. We present the case of a 47-year-old man with thyrotoxicosis secondary to Graves' disease with hepatic biochemical involvement manifested as intrahepatic cholestasis refractory to medical management in the short term, successfully managed with plasmapheresis as bridge therapy to total thyroidectomy, providing an analysis of the response to therapy through a change in free thyroxine (T4) and total bilirubin levels throughout his evolution.
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