Challenges in Managing Graves’ Disease with Coexisting Acute-on-chronic Liver Disease

A BSTRACT Deranged liver enzymes in a patient with thyrotoxicosis can result from the impact of hyperthyroidism on liver function, side effects of antithyroid drugs, or coexisting chronic liver disease. These overlapping causes can complicate both diagnosis and treatment, requiring careful consideration in management strategies. We present the case of a 28-year-old female who presented with coexisting Graves’ disease and acute-on-chronic liver disease. The timely initiation and careful consideration of various medical management strategies were essential for the successful treatment and favorable prognosis of the patient.