Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Background: The liver plays an important role in the metabolism of thyroid hormones, as it is the most important organ in the peripheral conversion of tetraiodothyronine (T4) totriiodothyronine(T3) by Type 1 deiodinase. Moreover, the liver is involved in thyroid hormone conjugation and excretion, as well as the synthesis of thyroid binding globulin.T4 and T3 regulate the basal metabolic rate of all cells, including hepatocytes, and thereby modulate hepatic function. The liver metabolizes the thyroid hormones and regulates their systemic endocrine effects.Thyroid diseases may perturb liver function; liver disease modulates thyroid hormone metabolism, and a variety of systemic diseases affect both the organs. Although patients of cirrhosis are mostly euthyroid clinically, many studies in the past have reported variousabnormalities in the circulating thyroid hormones. Patients with chronic liver disease may have thyroiditis, hyperthyroidism, or hypothyroidism, so the thyroid function test can be helpful as a prognostic marker for the severity of liver cirrhosis.Methods: Our study included 90 patients of liver cirrhosis and 30 normal subjects.The patients were classified according to the ModifiedChild-Pugh score into 3 groups: 30 patients (Child A), 30 patients (Child B) and 30 patients (Child C). All patients were subjected to thorough history taking, full laboratory investigations including thyroid profile (TSH, FT3 and FT4), abdominal ultrasound, upper endoscopy and calculation of MELD score.Results: Compared to control, the mean TSH level in cirrhotic patients was significantly low (p<0.001), and 31.1% of patients of liver cirrhosis had low TSH level. Compared to control, the mean FT3 level in cirrhotic patients was significantly high (p=0.037), and 5.6% of patients of liver cirrhosis had high FT3 level

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