[Diagnosis and treatment of new-onset or uncontrolled hyperthyroidism-induced liver injury].

The thyroid gland is the largest endocrine gland in the human body, which mainly secretes thyroid hormones. Thyroid hormone acts on almost all tissues and cells at different level regulating growth and development, metabolism and other functional activities of the body. Therefore, abnormal thyroid function can affect the multiple organs throughout the body. Liver, as the largest biochemical plant in the whole body, is widely regulated by thyroid hormones, and is one of the important target organs of the thyroid gland. Hyperthyroidism (HT for short) is a common disease of the endocrine system, which can cause liver injury, such as hepatomegaly, abnormal liver function, jaundice, cirrhosis, and liver failure. This phenomenon is also known as hyperthyroidism-induced liver injury, and it is more common in new or untreated or improperly treated patients with hyperthyroidism. The basic liver function test at the beginning of antithyroid drugs (ATD) treatment can clarify the degree of liver injury caused by hyperthyroidism itself, and further predict the additional liver injury with ATD therapy initiation. The core of treating hyperthyroidism-induced liver injury is to rapidly control hyperthyroidism, and restore normal liver function. This review briefly summarizes the incidence rate, possible mechanisms, pathological changes, clinical manifestations, laboratory, imaging and pathologic findings, and the recent advances in diagnosis and treatment of the hyperthyroidism-induced liver injury.甲状腺是人体最大的内分泌腺，主要分泌甲状腺激素。甲状腺激素几乎作用于机体所有组织及细胞，多层次、多水平地调节机体的生长发育、新陈代谢等功能活动。甲状腺功能出现异常时，可累及全身多脏器，而肝脏作为全身最大的生化工厂，广泛地受到甲状腺激素的调节，是甲状腺重要的靶器官之一。甲状腺功能亢进症（简称甲亢）是内分泌系统常见病，可引起肝脏损害，表现为肝肿大、肝功能异常、黄疸甚至肝硬化、肝衰竭等，称为甲亢性肝损伤，多见于新发或未治疗或治疗不当的甲亢患者。在开始抗甲状腺药物（ATD)治疗前，应检查基础肝功能，一方面用于明确甲亢本身导致的肝损伤程度，另一方面用以鉴别ATD引起的药物性肝损伤。治疗甲亢性肝损伤的核心应是迅速控制甲亢，当甲亢得到控制时肝功能也常恢复正常。现总结甲亢导致的肝脏损伤以及肝功能衰竭的发病率、可能的机制、病理改变、临床表现、实验室检查、影像及病理检查、最新的诊断与治疗方案进展。.