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Hypothyroidism as a Mimic of Liver Failure in a Patient with Cirrhosis

Raed N. Khairy, MD; and Kevin D. Mullen, MD
[+] Article, Author, and Disclosure Information

From University of Michigan Health System, Ann Arbor, Michigan, and Case Western Reserve University and MetroHealth Medical Center, Cleveland, Ohio.

Potential Financial Conflicts of Interest: None disclosed.

Ann Intern Med. 2007;146(4):315-316. doi:10.7326/0003-4819-146-4-200702200-00021
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Hypothyroidism Mimicing Liver Failure
Posted on March 8, 2007
Brett W. Stephens
University of Texas Medical School at Houston
Conflict of Interest: None Declared


I read with interest the letter from Khairy and Mullen (1) emphasizing the need to consider hypothyroidism as the cause of intractable ascites and encephalopathy in patients with cirrhosis confirmed by liver biopsy. In an article related to this topic, Fred (2) emphasized that in anyone with conspicuous ascites, four "curable" causes should always be considered "“ constrictive pericarditis, pancreatitis with pseudocyst formation, myxedema, and tuberculous peritonitis. He observed nine patients, all with histologically proven cirrhosis, whose ascites resolved with treatment for pancreatitis with pseudocyst formation (four), tuberculous peritonitis (two), myxedema (two), and constrictive pericarditis (one).

Brett Stephens, MD University of Texas Medical School at Houston Houston, TX 77030


1. Khairy RN, Mullen KD. Hypothyroidism as a mimic of liver failure in a patient with cirrhosis. Ann Intern Med. Feb. 20, 2007; 146(4): 315-316.

2. Fred, HL. Curable conspicuous ascites: The forgotten four. Hospital Practice. October 15, 1999; 98-100.

Conflict of Interest:

None declared

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