{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:38:58Z","timestamp":1788554338615,"version":"build-2803163510"},"reference-count":54,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Funds of Chinese National Natural Science Foundation Project","award":["81460124, 81860114"],"award-info":[{"award-number":["81460124, 81860114"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>Early identification of the causes of cholestasis is important for appropriate management of patients with hyperthyroidism. We report a patient who had hyperthyroidism and severe cholestasis after methimazole (MMI) treatment. The patient was diagnosed as having MMI-induced cholestatic hepatitis. Treatment with MMI was stopped at admission to hospital. However, his serum total bilirubin (TBil) level rose from 410.5\u2009\u00b5mol\/L to 519.9 \u00b5mol\/L and prothrombin time activity (PTA) dropped from 81.0% to 52.2% in 10 days. To prevent further deterioration of his liver function, plasma exchange was performed three times, and dexamethasone (10\u2009mg, intravenously) was used each time. His PTA rose to 101% and his TBil continued to increase to 669.8\u2009\u00b5mol\/L after plasma exchange. He was subsequently diagnosed as having thyrotoxicosis-induced cholestasis and treated with radioactive iodine (380 MBq) 2 weeks after admission. His hyperthyroidism was significantly relieved, but the TBil level further increased to 776.8\u2009\u00b5mol\/L. Three weeks after admission, oral prednisone (30 mg\/day) was used in this patient. Subsequently, his TBil levels gradually decreased and his liver function almost normalized within 3 months. We discuss the literature on cholestasis in the context of hyperthyroidism.<\/jats:p>","DOI":"10.1177\/0300060519891018","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T05:12:20Z","timestamp":1576473140000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Challenges in early identification of causes and treatment of cholestasis in patients with hyperthyroidism: a case report and literature review"],"prefix":"10.1177","volume":"48","author":[{"given":"Baimei","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 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