Abstract: Objective This study aimed at summarizing the clinical features and risk factors of liver injuries in patients with hyperthyroidism (HT). Methods 216 patients with HT were encountered in our hospital between January 2018 and May 2022, and all took methimazole orally. The patients with drug-induced liver injuries (DILI) were treated by liver-protecting medicines. Serum free triiodothyronine (FT3), free thyroxine (FT4), alanine aminotransferase (ALT) and aspartate transaminase (AST) levels were routinely obtained. Results During the process of clinical management, the DILI was found in 102 cases (47.2%); the age, percentage of alcohol-taking, concomitant diabetes, large dose of methimazole administration, high serum FT3 and FT4 levels in patients with HT and DILI were (49.5±10.7)yr, 44.1%, 31.4%, 62.8%,(19.0±5.8)pmol/L and (60.4±18.4)pmol/L, significantly older or higher than[(44.0±14.5)yr, 30.7%, 6.1%, 21.0%, (16.6±4.2)pmol/L and (32.3±9.8)pmol/L, respectively, P<0.05] in 114 patients without DILI; the multivariate Logistic analysis showed that the concomitant diabetes[OR:1.8(95%CI:1.1-2.8)], large dose of methimazole administration [OR:1.6(95%CI:1.0-2.4)] and high serum FT4 level[OR:1.6(95%CI:1.2-2.1)] were all the independent risk factors for the occurrence of DILI (P<0.05); after treatment, serum FT3 and FT4 levels in patients with HT and DILI were (15.9±4.7)pmol/L and (40.1±12.5)pmol/L, both much lower than[(20.6±7.3)pmol/L and (70.5±23.3)pmol/L, respectively, P<0.05] before treatment, and serum ALT and AST levels were (23.5±4.8)U/L and (29.1±6.2)U/L, both much lower than[(88.9±26.4)U/L and (64.6±18.7)U/L, P<0.05] at the time of DILI diagnosed. Conclusion The clinicians should take the precipitating factors of DILI into consideration in patients with HT, and prescribe carefully medicines for them to decrease the incidence of DILI.

Key words: Hyperthyroidism, Drug-induced liver damage, Clinical feature, Risk factors