Grave’s Disease with Severe Hepatic Dysfunction: A Diagnostic and Therapeutic Challenge

Table 1

Baseline investigations of the patient.

TSH (mIU/L)	0.056	Serum alkaline phosphatase (SAP) (U/L) (38–126)	364
FT4 (ng/dL) (0.89–1.7)	3.45	S. albumin (g/dL)	3.3
T3 (nmol/L) (1.25–2.74)	4.56	Prothrombin time (sec)	14.2
Anti-TPO Ab (IU/dL)	450	Serum CPK	Normal
Bilirubin (total) (mg/dL)	15.8	USG abdomen	Hepatomegaly with periportal cuffing suggestive of acute hepatitis
Conjugated (mg/dL)	12.6	Viral markers (HVB, HCV, HAV, and HEV)	Negative
Unconjugated (mg/dL)	1.5	Arterial blood gas analysis (ABG)	Normal
AST (U/L)	46	24-hour urinary potassium	Normal
ALT (U/L)	43	S. Na^+/K^+ (mmol/L)	134/2.7