• Xiaoqiang Liu, Boming Xu, Yilin Zeng, Peizhong Chen, and Yubin Wang.
• Department of Gastroenterology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
• Medicine (Baltimore). 2023 Nov 10; 102 (45): e35972e35972.

RationaleWe present a case of a 43-year-old female patient diagnosed with hyperthyroidism. This study aims to demonstrate the rare association between hyperthyroidism and severe cholestatic jaundice, and the effectiveness of methimazole treatment.Patient ConcernsThe patient developed severe jaundice, a typically mild symptom in most hyperthyroidism cases.DiagnosisThe severe jaundice was suspected to be a result of cholestasis induced by hyperthyroidism, with other potential causes such as drug-induced or autoimmune liver dysfunction being ruled out.OutcomesThe patient was effectively treated with methimazole. Outcomes: Treatment with methimazole alleviated the severe cholestatic jaundice and restored normal thyroid function.LessonsThe specific mechanism of cholestasis as a secondary complication of hyperthyroidism remains unclear, and there are no specific biochemical markers for cholestasis caused by this hormonal disease. This case underscores the possibility of severe jaundice as a clinical manifestation of hyperthyroidism, and highlights antithyroid drug treatment as an effective strategy for managing severe cholestatic jaundice.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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