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Category: Volume 08 Issue 07 July 2020
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Title: Thyroid Profile as a Marker of Hepatic Encephalopathy Severity in Hepatitis B and C Related Cirrhosis

Authors: Dr Gursimranpal Singh Shergill, Dr Varun Mehta, Dr Dinesh Gupta, Dr Arshdeep Singh, Dr Priyanka Sharma

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.62

Abstract

Objective: The spectrum of thyroid hormone profiles in hepatitis B and hepatitis C related hepatic cirrhosis were assessed in order to find if there is any correlation between thyroid hormone levels and severity of liver disease.

Materials and Methods: The study was carried out over a period of one year and involved 85 patients with HBV or HCV related cirrhosis. Of the 85, there were 58 male and 27 female patients with a mean age of 55 years. Patients diagnosed with hepatic cirrhosis due to hepatitis B or C were selected and evaluated for thyroid function. Child-Pugh and model for end-stage liver disease (MELD) scores were also calculated. On the basis of the result of thyroid function tests, patients were divided into three groups with low, normal, or high range of thyroid hormones, for each TSH, fT3 and fT4. The thyroid hormones were correlated with the severity of liver disease by assessing various factors (irrelevant talk for encephalopathy, ascites, total bilirubin, albumin, prothrombin time, Child-Pugh and MELD scores for severity of liver disease).

Results: Patients with a low fT3 levels (fT3 normal range 3.10-6.80 pmol/L) were significantly more likely to have irrelevant talk and hence encephalopathy (p < 0.001).  Low fT3 levels also correlated with a higher Child-Pugh score C (p< 0.001) and were much more likely to have a higher MELD score (P < 0.001).

Conclusion: The serum fT3 levels are a very good indicator of liver function in those with HBV or HCV related cirrhosis. FT3 levels decrease as the severity of liver diseases increases.

Keywords: hepatitis B and C related cirrhosis, thyroid profile, Child-Pugh score,model for end-stage liver disease (MELD score), thyroid hormone profiles.

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Corresponding Author

Dr Gursimranpal Singh Shergill

Senior Resident, Department of Medicine, Dayanand Medical College, Ludhiana