Effect of acute and chronic liver diseases on the thyroid function in children

BMC Pediatr. 2021 Aug 25;21(1):361. doi: 10.1186/s12887-021-02816-8.

Abstract

Background: Thyroid hormones modulate hepatic function through regulation of basal metabolic rate in addition; the liver metabolizes the thyroid hormones and regulates their endocrine effects.

Objectives: To assess thyroid functions in children with acute and chronic liver diseases.

Methods: 85 studied children were divided into 4 groups; group 1 (20 children) with acute hepatitis (AH), group 2 (20 children) chronic liver disease1 (CLD1; relatively preserved liver functions including Child-Pugh stage A), group 3 (20 children) chronic liver disease2 (CLD2; includes Child-Pugh stage B or C), group 4 (25 children) controls. All groups were subjected to detailed history, physical examination, Complete blood count, liver, renal function tests, viral markers, and thyroid functions (FT3, FT4, TSH).

Results: Free T3 levels were lower in children with AH, CLD1 and CLD2. There was significant increase in TSH serum levels in CLD2.In acute hepatitis a negative correlation between serum free T4 and AST (r = -0.991), positive correlation between serum TSH and AST, VLDL, and cholesterol levels (r= 0.503, 0.533 and 0.498). A positive correlation between free T3 levels and prothrombin concentration (r= 0.991). Negative correlations between free T3 levels and PT, serum bilirubin and LDL serum levels in children with CLD2 (r= -0.992) (r= -0.902) and (r= -0.946) CONCLUSION: Acute and chronic liver diseases affect thyroid function in children and is correlated with the disease severity.

Keywords: Acute hepatitis; Chronic liver disease; Thyroid function tests.

MeSH terms

  • Humans
  • Liver Diseases* / etiology
  • Liver Function Tests
  • Thyroid Function Tests
  • Thyroid Gland* / diagnostic imaging
  • Thyrotropin
  • Thyroxine
  • Triiodothyronine

Substances

  • Triiodothyronine
  • Thyrotropin
  • Thyroxine