J Korean Endocr Soc.  2009 Dec;24(4):287-292. 10.3803/jkes.2009.24.4.287.

A Case of Hashimoto's Thyroiditis Accompanied by Autoimmune Hepatitis Diagnosed with Liver Biopsy

• Lee YJ
• Sung JY
• Kim SH
• Yi HS
• Kim YS
• Lee S
• Park IB

• KMID: 1468550
• DOI: http://doi.org/10.3803/jkes.2009.24.4.287

Abstract

Autoimmune thyroid diseases, including Hashimoto's thyroiditis (HT), are common organ-specific autoimmune disorders that often occur in conjunction with other autoimmune diseases. Autoimmune hepatitis (AIH) is a relatively rare disease of unknown etiology. In this condition, progressive destruction of the liver parenchyma occurs. Without proper treatment with immunosuppressive agents, such as prednisone and azathioprine, this condition leads to cirrhosis and liver failure. Timely detection and appropriate treatment of the AIH is prerequisite for the long-term survival of affected patients. We report here a case of HT accompanied by AIH confirmed by liver biopsy. On the basis of this case report, we suggest that, a sustained elevation of aminotransferases refractory to thyroid dysfunction correction should result in a liver biopsy to differentiate AIH from other forms of liver dysfunction or secondary to thyroid disorders. Treatment should commence promptly.

Keyword

autoimmune hepatitis; Hashimoto's thyroiditis; liver biopsy

MeSH Terms

Autoimmune Diseases
Azathioprine
Biopsy
Fibrosis
Hepatitis, Autoimmune
Humans
Immunosuppressive Agents
Liver
Liver Diseases
Liver Failure
Prednisone
Rare Diseases
Thyroid Diseases
Thyroid Gland
Thyroiditis
Transaminases
Azathioprine
Immunosuppressive Agents
Prednisone
Transaminases

Figure

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  Fig. 1 Ultrasonography of patient's thyroid gland. Irregular and hypoechoic lesions were compatible with Hashimoto's thyroiditis.

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  Fig. 2 Ultrasonography of patient's liver. Increased echogenecity was indicative of diffuse liver parenchymal disease.

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  Fig. 3 Pathologic findings of liver biopsy. A. Marked infiltrations of portal and periportal lymphocytes and macrophages were noted, which is a typical finding of chronic hepatic inflammation (×100). B. Periportal necrosis and portal fibrosis with plasma cell reaction were seen, which is compatible with autoimmune hepatitis (×400).

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