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Corresponding Author

Ahmed Ismail Ahmed Yasseen

Document Type

Original Article

Abstract

Background: Subclinical hypothyroidism (SCH) is a condition marked by increased concentrations of thyroid-stimulating hormone (TSH) in the bloodstream, along with normal thyroxine (T4) and triiodothyronine (T3) concentrations.

Aims and objectives: To assess the benefits of levothyroxine replacement treatment in SCH cases with chronic hepatic encephalopathy (HE),

Patients and methods: This comparative research was performed on 50 Egyptian cases aged 18–65 with SCH and chronic HE, separated into two groups: Group I: 25 cases did not receiveLT4 replacement therapy, and Group II: 25 patients received LT4 replacement therapy chosen from the outpatient clinic of & admitted to the Internal Medicine department of Sayed Galal Hospital Al-Azhar University from May 2023 to November 2023.

Results: Regarding liver function tests following six months, there was a statistically significant variance among Group I and Group II as regards aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT). Regarding thyroid function tests and lipid profile following six months, there was statistically significant variance among groups I and II with regard to TSH and HE grade and a highly statistically significant distinction with regard to ammonia and triglycerides (TGs). Regarding the Child-Pugh score and hepatic encephalopathy frequency following six months, there was a statistically significant distinction between groups I and II.

Conclusion: SCH can trigger HE in cirrhotic individuals, which can lead to hyperammonemia and/or worsen ammonia brain toxicity. Thus, it is important to assess for hypothyroidism in patients with cirrhosis and refractory HE, especially when considering aggressive therapies.

Keywords

SCH; HE; Levothyroxine

Subject Area

Internal Medicine

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