Hepatocellular carcinoma is accompanied by a significant increase in serum reverse triiodothyronine (rT3) levels in patients with low-grade liver cirrhosis related to hepatitis C virus (HCV) who have no other illness causing the ‘euthyroid sick syndrome’.
Dr F Sorvillo and colleagues undertook a study to investigate the relation between changes in thyroid hormone metabolism and hepatocellular carcinoma. Thirty one patients with HCV-related liver cirrhosis who also had hepatocellular carcinoma were studied (median age 62.1 years; range 54-81.5 years). The control group consisted of 29 patients affected by HCV-related liver cirrhosis without hepatocellular carcinoma, matched for sex, age and grade of liver dysfunction.
The researchers found that at the time hepatocellular carcinoma was diagnosed, all patients in the study group were euthyroid with serum TSH, FT4, FT3 and thyroxine-binding globulin values not significantly different from those of cirrhotic patients in the control group. In contrast, at diagnosis the study group patients had serum rT3 values that were significantly higher than those in the control group. In the study group, 38.7% of patients had serum rT3 values above normal, but only 3.4% in the control group did so.
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