Thyroid and Hepatic Haemodynamic Alterations among Egyptian Children with Liver Cirrhosis

Abstract

Background. Alterations in thyroid hormones regulation and metabolism are frequently observed in patients with cirrhosis. Aims. To assess alterations in thyroid volume (TV), haemodynamics, and hormones in patients with cirrhosis and their relation to hepatic arterial haemodynamics, and disease severity. Methods. Forty cirrhotic patients were compared to 30 healthy subjects regarding TV, free triiodiothyronine (fT3), free tetraiodothyronine (fT4), thyroid stimulating hormone (TSH), and pulsatility and resistance indices in the inferior thyroid and hepatic arteries. Results. TV (P = 0.042), thyroid volume standard deviation score (TVSDS, P = 0.001), Inferior Thyroid Artery Pulsatility Index (ITAPI, P = 0.001), Inferior Thyroid Artery Resistance Index (ITARI, P = 0.041), Hepatic Artery Pulsatility Index (HAPI, P = 0.029) and Hepatic Artery Resistance Index (HARI, P = 0.035) were higher among cases being highest in Child-C patients. FT3 was lower in patients than controls (P = 0.001) and correlated negatively with ITAPI (r = −0.71, P = 0.021) and ITARI (r = −0.79, P = 0.011). ITAPI and ITARI correlated directly with HAPI and HARI (r = 0.62, P = 0.03, and r = 0.42, P = 0.04, resp.). Conclusions. Thyroid is involved in the haemodynamic alterations of cirrhosis. Routine study of thyroid by Doppler and assessment of thyroid functions should be performed in patients with cirrhosis to offer proper treatment if needed.

Development and validation of a novel score for fibrosis staging in patients with chronic hepatitis B

“…Decreased levels of TT3 and TT4 have been observed in cirrhotic patients, with a negative correlation with cirrhosis severity . The FT3 level was also found to be lower in cirrhotic patients than in controls . However, previous studies have revealed contradictory FT4 alterations in cirrhotic patients .…”

“…18,38,39 The FT3 level was also found to be lower in cirrhotic patients than in controls. 40 However, previous studies have revealed contradictory FT4 alterations in cirrhotic patients. 41 is available on fibrosis or early cirrhosis, especially the dynamic alterations in thyroid hormones with the METAVIR fibrosis score.…”

The Value of Fibrosis Index in Discrimination of Chronic Hepatitis and Cirrhosis

“…Birçok çalışmada siroz hastalarında HARI değerinin arttığı gösterilmiştir (2,5,10,(13)(14)(15). El-Kabbany ve ark.…”

“…Doppler US, B mod US bulguları normal olan kronik karaciğer hastalarında dahi karaciğer hemodinamisindeki değişiklikleri belirler ve ayrıca kalitatif ve kantitatif ölçümlere olanak sağlar (7). Birçok araştırmacı farklı Doppler parametreleri kullanarak bu hemodinamik değişiklikleri değerlendirmeye çalışmıştır (2,5,(8)(9)(10). Kronik karaciğer hastalığı ve sirozu ayırmada fibrozis indeksi tanımlanmış ve fibrozis indeksinin siroz hastalarında daha yüksek olduğu bulunmuştur (11).…”

Prevalence of thyroid disorders and the correlation of thyroid profile with liver enzymes, serum activin-A and follistatin during the treatment of patients with chronic hepatitis C genotype 1 and 4

“…Non-alcoholic fatty liver diseases and abnormal liver enzymes are significantly associated with hypothyroidism and the the prevalence of liver diseases and enzymes increase steadily with increasing grades of hypothyroidism [34]. Furthermore, a decrease in serum T3 concentration and T3:T4 ratio is frequently observed in patients with liver cirrhosis probably due to impaired conversion of T4 to T3 in the liver [35]. Thyrotoxicosis is also associated with a variety of abnormalities of liver function [36] and results from a recent study suggests that low FT4 concentrations are associated with hepatic steatosis [37].…”