Evaluation of Thyroid Functions in Cirrhotic Patients with Refractory Ascites

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Background and study aim: Disturbance of thyroid functions was observed in patients with advanced liver cirrhosis. This ‎study aimed to assess thyroid hormone levels in cirrhotic patients and to evaluate the ‎relationship between thyroid function disturbances and cirrhotic patients with refractory ascites‎‎‎‎‎‎.‎ Methods: ‎‎‎ This study included 244 cirrhotic patients enrolled into 3 groups: group A included 122 ‎cirrhotic patients with refractory ascites, group B included 62 cirrhotic patients with ascites and ‎Group C included 60 cirrhotic patients without ascites. All patients were evaluated by complete ‎blood count, liver functions, kidney functions, coagulation profiles, serology for viral hepatitis, ‎serum Na, serum K, urine analysis, thyroid function tests, and abdominal ultrasonography‎‎‎.‎ Results: In group A, 21.3 % of patients had high TSH levels, 14.8 % had low free T3 levels and 9.8 % ‎had low free T4 levels. Cirrhotic patients with refractory ascites had a statically significant ‎lower levels of free T3 (2.43 ± 0.66) and free T4 (1.16 ± 0.21) (P > 0.05), but no significant ‎difference as regard TSH levels compared to cirrhotic patients without ascites. Child C cirrhotic ‎patients had a statistically significantly lower levels of free T3 (2.44 ± 0.68) and free T4 (1.16 ± ‎‎0.21) compared to child A cirrhotic patients (P > 0.05)‎‎‎‎‎. Conclusion: The percentage of elevated TSH levels and decreased free T3 and T4 levels was more in ‎cirrhotic patients with refractory ascites. Hypothyroidism could be a risk factor for the ‎occurrence of refractory ascites in patients with advanced liver cirrhosis ‎‎‎.