*Corresponding author:Ken Sato, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
Received: April 15, 2018; Published: April 24, 2018
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A 71-year-old man suffering from non-alcoholic fatty liver disease, diabetes and dyslipidemia was hospitalized for elevated creatine phosphokinase levels. Discontinuation of antihyperlipidemic agents and rehydration could not normalize creatine phosphokinase levels. Findings of liver biopsy were compatible with non-alcoholic steatohepatitis. Based on the detailed evaluations, he was diagnosed as hypothyroidism. Thyroid hormone replacement therapy gradually improved his thyroid function and creatine phosphokinase levels. Notably, the repeated liver biopsy after the therapy showed histological improvement of steatosis. We should suspect “subclinical” hypothyroidism in case of unexplained elevation of creatine phosphokinase levels during the course or at the onset of non-alcoholic fatty liver disease / nonalcoholic steatohepatitis.
Keywords: Hypothyroidism; Non-Alcoholic Steatohepatitis; Dyslipidemia; Creatinine Phosphokinase
Abbreviations: CK: Creatine Phosphokinase; TSH: Thyroid Stimulating Hormone; NASH: Non-Alcoholic Steatohepatitis; DL: Dyslipidemia; ALT: Alanine Aminotransferase; DM: Diabetes Mellitus; BMI: Body Mass Index; AST: Aspartate Aminotransferase; LDL: Low-Density Lipoprotein Cholesterol; HbA1c: Hemoglobin A1c; NAFL: Non-Alcoholic Fatty Liver Disease; VLDL: Very Low Density Lipoprotein; FGF-21: Fibroblast Growth Factor-21; ATP: Adenosine Triphosphate; HMG-CoA: Hydroxy Methyl Glutaryl-CoA