Severe alcoholic hepatitis in a hypothyroid patient.

A treated hypothyroid patient with chronic alcoholism stopped replacement therapy with the onset of heavy drinking. The resulting hypothyroid state did not protect against an eventually fatal termination of acute alcoholic liver disease. Unlike the controlled trials of anti-thyroid therapy for alcoholic hepatitis, this experience simulates the animal experiments suggesting a hypermetabolic mechanism in alcohol hepatotoxicity. The outcome in this instance, however, is not supportive of this hypothesis.