Graves Disease: “Unusual Presentation”

Ahmed M. Badi, Hassan O.Abuzaid, Mohamed M.Abohmira, Akshay Athreya

Hyperthyroidism is known to cause derangement in liver function. However, hyperthyroidism presenting solely with jaundice and no other symptoms is a rare occurrence. We report a patient who presented to the hospital with severe itching and jaundice. Liver function tests done initially showed a conjugated hyperbilirubinemia and elevation in liver enzymes. Imaging studies, auto immune workup for liver diseases, hepatitis serology were all negative. Thyroid function test revealed a picture of hyperthyroidism with strongly positive anti thyroid peroxidase antibodies.This case highlights the importance of considering thyroid diseases in cases of jaundice where no obvious causes can be identified. Treatment with anti-thyroid medications can provide significant relief.