Cholestasis induced hyperthyroidism after liver transplantation.

We report the case of a 68-year-old woman who underwent liver transplantation because of hepatitis-C-induced cirrhosis. She developed iodine-reduced hyperthyroidism postoperatively in temporal relation with cholestatic jaundice. Hepatic biopsies revealed moderate intrahepatic cholestasis and mild lobular inflammatory infiltration with some eosinophils. No histological evidence of acute graft rejection or reactivated hepatitis was found. Treatment with methimazole markedly reduced the serum parameters of cholestasis which, after subtotal thyroidectomy, returned to normal. Liver function recovered, as confirmed by repeated aminopyrine breath tests.