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Published in: Virology Journal 1/2016

Open Access 01-12-2016 | Case Report

Graves’ hyperthyroidism accompanied with acute hepatitis B virus infection: an extrahepatic manifestation?

Authors: Wei Cui, Baocheng Deng, Wen Wang, Pei Liu

Published in: Virology Journal | Issue 1/2016

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Abstract

Background

Although hepatitis B virus (HBV) primarily affects hepatocytes, it has also been shown to cause complications in the skin, joints, muscles, and kidneys. Thyroid dysfunction is uncommon in cases of acute HBV infection.

Case presentation

In this report, we describe a case of a 46-year-old woman with incipient acute hepatitis B virus (HBV) infection who presented clinically with Graves’ hyperthyroidism. She showed typical symptoms of hyperthyroidism, and laboratory tests revealed high levels of HBV DNA and alanine transaminase (ALT). The patient was not administered with antithyroid medicine or radioiodine, but she was given antiviral therapy and symptomatic treatment with propranolol. Follow-up studies showed that as the HBV DNA levels decreased, the thyroid function recovered.

Conclusion

Graves’ disease maybe an extrahepatic manifestation of acute HBV infection. Antiviral therapy is likely to be beneficial for this condition as without severe thyrotoxicosis.
Literature
1.
go back to reference Terrier B, Cacoub P. Hepatitis B virus, extrahepatic immunologic manifestations and risk of viral reactivation. Rev Med Interne. 2011;32:622–7.CrossRefPubMed Terrier B, Cacoub P. Hepatitis B virus, extrahepatic immunologic manifestations and risk of viral reactivation. Rev Med Interne. 2011;32:622–7.CrossRefPubMed
3.
go back to reference Nagata K, Nakayama Y, Higaki K, Ochi M, Kanai K, Matsushita M, Kuwamoto S, Kato M, Murakami I, Iwasaki T, Nanba E, Kimura H, Hayashi K. Reactivation of persistent Epstein-Barr virus (EBV) causes secretion of thyrotropin receptor antibodies (TRAbs) in EBV-infected B lymphocytes with TRAbs on their surface. Autoimmunity. 2015;48:328–35.CrossRefPubMed Nagata K, Nakayama Y, Higaki K, Ochi M, Kanai K, Matsushita M, Kuwamoto S, Kato M, Murakami I, Iwasaki T, Nanba E, Kimura H, Hayashi K. Reactivation of persistent Epstein-Barr virus (EBV) causes secretion of thyrotropin receptor antibodies (TRAbs) in EBV-infected B lymphocytes with TRAbs on their surface. Autoimmunity. 2015;48:328–35.CrossRefPubMed
4.
go back to reference Kappus MR, Sterling RK. Extrahepatic manifestations of acute hepatitis B virus infection. Gastroenterol Hepatol (N Y). 2013;9:123–6. Kappus MR, Sterling RK. Extrahepatic manifestations of acute hepatitis B virus infection. Gastroenterol Hepatol (N Y). 2013;9:123–6.
5.
go back to reference Czaja AJ, Carpenter HA, Santrach PJ, Moore SB. Immunologic features and HLA associations in chronic viral hepatitis. Gastroenterology. 1995;108:157–64.CrossRefPubMed Czaja AJ, Carpenter HA, Santrach PJ, Moore SB. Immunologic features and HLA associations in chronic viral hepatitis. Gastroenterology. 1995;108:157–64.CrossRefPubMed
6.
go back to reference Aleksandrova GF, Efuni SS, Lavrova IK, Savinov AP, Bel’chenko LV. The role of Coxsackie viruses in the pathogenesis of diffuse toxic goiter. Probl Endokrinol (Mosk). 1988;34:18–20. Aleksandrova GF, Efuni SS, Lavrova IK, Savinov AP, Bel’chenko LV. The role of Coxsackie viruses in the pathogenesis of diffuse toxic goiter. Probl Endokrinol (Mosk). 1988;34:18–20.
7.
go back to reference Jin HY, Kang SM, Kim SY, Park JH, Baek HS, Park TS. A case of Graves’ disease combined with hantaan virus infection. J Korean Med Sci. 2009;24:158–61.CrossRefPubMedPubMedCentral Jin HY, Kang SM, Kim SY, Park JH, Baek HS, Park TS. A case of Graves’ disease combined with hantaan virus infection. J Korean Med Sci. 2009;24:158–61.CrossRefPubMedPubMedCentral
8.
go back to reference Yoffe B, Burns DK, Bhatt HS, Combes B. Extrahepatic hepatitis B virus DNA sequences in patients with acute hepatitis B infection. Hepatology. 1990;12:187–92.CrossRefPubMed Yoffe B, Burns DK, Bhatt HS, Combes B. Extrahepatic hepatitis B virus DNA sequences in patients with acute hepatitis B infection. Hepatology. 1990;12:187–92.CrossRefPubMed
9.
go back to reference Tas A, Beyazit Y, Olmez S, Celik H, Aktas S. Can subacute thyroiditis be associated with acute hepatitis B virus infection? Wien Klin Wochenschr. 2012;124:348–9.CrossRefPubMed Tas A, Beyazit Y, Olmez S, Celik H, Aktas S. Can subacute thyroiditis be associated with acute hepatitis B virus infection? Wien Klin Wochenschr. 2012;124:348–9.CrossRefPubMed
11.
go back to reference Mancini A, De Marinis L, Fiumara C, Della Casa S, D’Amico C, Sambo P, Tofani A, Calabro F, Saporosi A, Sciuto R, et al. The role of autoimmune mechanisms in the hyperthyroidism-viral hepatitis syndrome: a possible noncausal association. A review of the literature and the authors’ own cases. Minerva Med. 1990;81:249–54.PubMed Mancini A, De Marinis L, Fiumara C, Della Casa S, D’Amico C, Sambo P, Tofani A, Calabro F, Saporosi A, Sciuto R, et al. The role of autoimmune mechanisms in the hyperthyroidism-viral hepatitis syndrome: a possible noncausal association. A review of the literature and the authors’ own cases. Minerva Med. 1990;81:249–54.PubMed
12.
go back to reference Noordeen F. Hepatitis B virus infection: An insight into infection outcomes and recent treatment options. Virusdisease. 2015;26:1–8.CrossRefPubMed Noordeen F. Hepatitis B virus infection: An insight into infection outcomes and recent treatment options. Virusdisease. 2015;26:1–8.CrossRefPubMed
13.
go back to reference Yi Z, Jie YW, Nan Z. The efficacy of anti-viral therapy on hepatitis B virus-associated glomerulonephritis: A systematic review and meta-analysis. Ann Hepatol. 2011;10:165–73.PubMed Yi Z, Jie YW, Nan Z. The efficacy of anti-viral therapy on hepatitis B virus-associated glomerulonephritis: A systematic review and meta-analysis. Ann Hepatol. 2011;10:165–73.PubMed
14.
go back to reference Zhao H, Tian GS. Differential clinical diagnostic parameters of acute hepatitis B and flare of chronic HBV infection. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2004;18:363–5.PubMed Zhao H, Tian GS. Differential clinical diagnostic parameters of acute hepatitis B and flare of chronic HBV infection. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2004;18:363–5.PubMed
15.
go back to reference Mason A. Role of viral replication in extrahepatic syndromes related to hepatitis B virus infection. Minerva Gastroenterol Dietol. 2006;52:53–66.PubMed Mason A. Role of viral replication in extrahepatic syndromes related to hepatitis B virus infection. Minerva Gastroenterol Dietol. 2006;52:53–66.PubMed
16.
go back to reference Nityanand S, Holm G, Lefvert AK. Immune complex mediated vasculitis in hepatitis B and C infections and the effect of antiviral therapy. Clin Immunol Immunopathol. 1997;82:250–7.CrossRefPubMed Nityanand S, Holm G, Lefvert AK. Immune complex mediated vasculitis in hepatitis B and C infections and the effect of antiviral therapy. Clin Immunol Immunopathol. 1997;82:250–7.CrossRefPubMed
17.
go back to reference Boglione L, D’Avolio A, Cariti G, Di Perri G. Telbivudine in the treatment of hepatitis B-associated cryoglobulinemia. J Clin Virol. 2013;56:167–9.CrossRefPubMed Boglione L, D’Avolio A, Cariti G, Di Perri G. Telbivudine in the treatment of hepatitis B-associated cryoglobulinemia. J Clin Virol. 2013;56:167–9.CrossRefPubMed
18.
go back to reference Soares DV, Nakamura LT, Ladeira MC, Brito SM, Henriques JL. Acute hepatic failure in a patient with hyperthyroidism and virus B hepatitis: recovery after plasmapheresis and thyroidectomy--a case report. Arq Bras Endocrinol Metabol. 2008;52:566–71.CrossRefPubMed Soares DV, Nakamura LT, Ladeira MC, Brito SM, Henriques JL. Acute hepatic failure in a patient with hyperthyroidism and virus B hepatitis: recovery after plasmapheresis and thyroidectomy--a case report. Arq Bras Endocrinol Metabol. 2008;52:566–71.CrossRefPubMed
Metadata
Title
Graves’ hyperthyroidism accompanied with acute hepatitis B virus infection: an extrahepatic manifestation?
Authors
Wei Cui
Baocheng Deng
Wen Wang
Pei Liu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2016
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/s12985-016-0537-z

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