Thyrotoxicosis Associated with Jaundice in a Human Immunodeficiency Virus (HIV) Infected Patient - Treatment Challenges in a Resource Constrained Tertiary Health Facility in South East, Nigeria.

Abstract

Thyrotoxicosis complicated by jaundice is not rare. In the presence of other co-morbid conditions, it may pose significant treatment challenges especially in resource constrained settings. There is a dearth of published case reports on thyrotoxicosis with liver dysfunction in a patient living with HIV infection, hence, we set out to highlight the challenges in their treatment.

A patient with thyrotoxicosis due to Graves disease with background HIV infection presented initially with heart failure and later jaundice in Abia State University Teaching Hospital (ABSUTH), Aba, Nigeria. Heart failure resolved before jaundice developed, therefore, hepatic congestion from heart failure may not account for the jaundice.

In conclusion, coexistence of HIV infection with Grave's disease and jaundice could present management challenges in view of possible hepatotoxic drug side effects and drug-drug interactions. Definitive treatment for Graves disease (surgery or radioiodine therapy) are options but are not available everywhere.

Key Words: Thyrotoxicosis, Liver Dysfunction, Jaundice, Graves disease, HIV Infection And HAART