Abstract
Hepatic dysfunction with thyroid storm presents a diagnostic challenge. A young male presented with symptoms suggestive of acute liver failure (ALF). Examination revealed bilaterally enlarged thyroid gland. Viral marker was positive for immunoglobulin M anti-hepatitis E virus. Thyroid profile revealed suppressed thyroid-stimulating hormone and raised T3 and T4. Working diagnosis of ALF due to viral hepatitis E and thyroid storm was made. The patient was stabilized with Lugol's iodine and lithium, after which he underwent total thyroidectomy. Postsurgery patient had significant clinical improvement and was put on oral thyroxine. He achieved normal liver function on subsequent follow-ups.
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