Journal of Clinical Case Reports

An Unusual Case of Grave’s Disease with Primary Sclerosing Cholangitis (PSC)

Abstract

Abdul-Rahman Mashi and Naji J Al- Johani

Grave’s disease is an autoimmune thyroid disease with multi-system involvement. It’s manifestations are diverse, including liver function abnormalities and association with other autoimmune disease. The objective of this report is to present an unusual case of Grave’s disease with PSC. This is a 28-year-old woman that present with cholestatic jaundice along with signs and symptoms of thyrotoxicosis. She diagnosed to have Grave’s disease with PSC. Despite an initial high bilirubin, treatment with antithyroid agents in addition to Ursodeoxycholic acid led to marked improvement in her clinical status and bilirubin level. The proposed mechanisms underlying the association of Grave’s disease with PSC are discussed and the literature on similar cases is highlighted. Both Grave’s disease and PSC have been shown to be associated with other autoimmune mediated diseases. This case report shows an association between Grave’s disease and PSC whether due to an underlying immune-genetic predisposition or coincidence. Further studies are needed to investigate this association.