SERUM THYROGLOBULIN IN ACUTE AND CHRONIC LIVER DISEASE

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Abstract
In view of the widespread use of serum thyroglobulin [Ig], determination in the follow-up of patients with differentiated thyroid carcinoma, the influence of acute and chronic liver disease on serum Tg concentration was investigated in 37 consecutive patients with histologically proven alcoholic liver cirrhosis and 23 patients with acute non-alcoholic hepatitis. Seventy-four healthy volunteers served as controls. Serum Tg concentration was significantly elevated in cirrhosis: median 29.5 .mu.g/l, (range 4.3-94.0 .mu.g/l) compared to controls: median 16.0 .mu.g/l, (range 4.8-8.96 .mu.g/l), (P < 0.001). Serum Tg concentration in patients with acute hepatitis: median 16.2 .mu.g/l, (range 7.9-70.0 .mu.g/l) was not significantly different from controls. The level of free T3 index was significantly reduced and the level of free T4 [thyroxine] index was significantly elevated in both cirrhosis and hepatitis compared to controls. Serum TSH concentration was significantly elevated in cirrhosis compared to hepatitis and controls. Serum Tg levels were positively correlated to levels of free T3 index (n = 0.35, P < 0.05) and T3/T4 ratio (r = 0.40, P < 0.05) but not to levels of serum TSH or free T4 index or any of the liver function tests in any of the groups. The results do not clearly indicate whether the elevated serum Tg level in cirrhosis was caused by an impaired elimination and/or an increased secretion from the thyroid gland. The increase in serum Tg concentration in chronic alcoholic liver disease was not of a magnitude likely to cause misinterpretation of results obtained during the follow-up of patients with differentiated thyroid carcinoma.