Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report

Abstract Background Levothyroxine is a synthetic thyroxine and is the treatment of choice for hypothyroidism. It is a prohormone with minimal intrinsic activity. The drug is de-iodinated in peripheral tissue to form triiodothyronine, which is the active thyroid hormone. On initiation of treatment, l...

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Main Authors: Abbas F. Hlaihel, Mudher Z. H. Al-Khairalla
Format: Article
Language:English
Published: BMC 2019-10-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13256-019-2244-z
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spelling doaj-26846bd4762f4e45b4d9a0b72fe4b7aa2020-11-25T04:08:28ZengBMCJournal of Medical Case Reports1752-19472019-10-011311510.1186/s13256-019-2244-zLevothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case reportAbbas F. Hlaihel0Mudher Z. H. Al-Khairalla1ThiQar Medical SchoolThiQar Lung Diseases CentreAbstract Background Levothyroxine is a synthetic thyroxine and is the treatment of choice for hypothyroidism. It is a prohormone with minimal intrinsic activity. The drug is de-iodinated in peripheral tissue to form triiodothyronine, which is the active thyroid hormone. On initiation of treatment, levothyroxine is titrated, and usually it is extremely well tolerated in the vast majority of patients. We report a case of a patient with self-limiting levothyroxine-induced liver injury, a rare adverse effect of this drug. Case presentation We report a case of a 34-year-old Mediterranean woman diagnosed with post-thyroidectomy hypothyroidism. She was commenced on levothyroxine and developed liver injury confirmed by noninvasive liver investigations. Complete recovery of the patient’s liver tests occurred upon cessation of the drug. Triiodothyronine was an appropriate treatment alternative. Conclusion Levothyroxine-induced liver injury is a rare, and in the present case report, a self-limiting, adverse effect. The diagnosis of our patient was confirmed via noninvasive diagnostic methods. Knowledge of this rare adverse effect is important in the differential diagnosis of patients who have commenced on levothyroxine and have deranged liver enzymes in the context of hypothyroidism.http://link.springer.com/article/10.1186/s13256-019-2244-zCase reportLevothyroxineHepatitisHypothyroidismTriiodothyronine
collection DOAJ
language English
format Article
sources DOAJ
author Abbas F. Hlaihel
Mudher Z. H. Al-Khairalla
spellingShingle Abbas F. Hlaihel
Mudher Z. H. Al-Khairalla
Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
Journal of Medical Case Reports
Case report
Levothyroxine
Hepatitis
Hypothyroidism
Triiodothyronine
author_facet Abbas F. Hlaihel
Mudher Z. H. Al-Khairalla
author_sort Abbas F. Hlaihel
title Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
title_short Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
title_full Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
title_fullStr Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
title_full_unstemmed Levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
title_sort levothyroxine-induced liver injury followed by complete recovery upon cessation of the drug: a case report
publisher BMC
series Journal of Medical Case Reports
issn 1752-1947
publishDate 2019-10-01
description Abstract Background Levothyroxine is a synthetic thyroxine and is the treatment of choice for hypothyroidism. It is a prohormone with minimal intrinsic activity. The drug is de-iodinated in peripheral tissue to form triiodothyronine, which is the active thyroid hormone. On initiation of treatment, levothyroxine is titrated, and usually it is extremely well tolerated in the vast majority of patients. We report a case of a patient with self-limiting levothyroxine-induced liver injury, a rare adverse effect of this drug. Case presentation We report a case of a 34-year-old Mediterranean woman diagnosed with post-thyroidectomy hypothyroidism. She was commenced on levothyroxine and developed liver injury confirmed by noninvasive liver investigations. Complete recovery of the patient’s liver tests occurred upon cessation of the drug. Triiodothyronine was an appropriate treatment alternative. Conclusion Levothyroxine-induced liver injury is a rare, and in the present case report, a self-limiting, adverse effect. The diagnosis of our patient was confirmed via noninvasive diagnostic methods. Knowledge of this rare adverse effect is important in the differential diagnosis of patients who have commenced on levothyroxine and have deranged liver enzymes in the context of hypothyroidism.
topic Case report
Levothyroxine
Hepatitis
Hypothyroidism
Triiodothyronine
url http://link.springer.com/article/10.1186/s13256-019-2244-z
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AT mudherzhalkhairalla levothyroxineinducedliverinjuryfollowedbycompleterecoveryuponcessationofthedrugacasereport
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