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Thyroid Function Tests Simulating Graves' Disease in Alcoholic Hepatitis

DAVID D. STUART, M.D.; and ALVIN L. SCHULTZ, M.D., F.A.C.P.
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Hennepin County Medical Center and The University of Minnesota Medical School; Minneapolis, Minnesota


Ann Intern Med. 1978;89(4):514-515. doi:10.7326/0003-4819-89-4-514
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The liver may be a major site of extrathyroidal conversion of thyroxine (T4) to triiodothyronine (T3). Patients with alcoholic liver disease of several types have been observed to have mild but significant elevations of serum thyrotropin (TSH) and free T4, and normal or low free T3 compared with control populations (1, 2). Estimated T3 production rate in patients with hepatic cirrhosis is substantially less than that of normal persons, whereas the production rate of reverse T3 is unchanged (3). These observations suggest that, in patients with liver disease, a compensatory increase in TSH and in thyroidal hormonogenesis occurs in response

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