Graves’ disease and autoimmune hepatitis overlap syndrome with coincidental simultaneous presentation in a pediatric patient

Grażyna Waśka; Katarzyna Gołąb-Jenerał; Katarzyna Górowska-Kowolik; Małgorzata Stojewska; Agnieszka Zachurzok

doi:10.5114/pedm.2026.160225

eISSN: 2083-8441
ISSN: 2081-237X

Pediatric Endocrinology Diabetes and Metabolism

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abstract:

Original paper

Graves’ disease and autoimmune hepatitis overlap syndrome with coincidental simultaneous presentation in a pediatric patient

Grażyna Waśka

¹

,

Katarzyna Gołąb-Jenerał

²

,

Katarzyna Górowska-Kowolik

³

,

Małgorzata Stojewska

³

,

Agnieszka Zachurzok

³

Specialist Hospital No. 1, Bytom, Poland
Department of Pediatric Endocrinology, Independent Public Clinical Hospital No. 1, Medical University of Silesia in Katowice, Zabrze, Poland
Department and Clinic of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Zabrze, Poland

Pediatr Endocrinol Diabetes Metab 2026; 32 (1): 71-76

DOI: https://doi.org/10.5114/pedm.2026.160225

Online publish date: 2026/03/30

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Introduction
Graves’ disease (GD) and autoimmune hepatitis (AIH) represent distinct autoimmune disorders affecting the thyroid and liver, respectively.

Case presentation
This report discusses a case of a 13-year-old boy with rare coexistence of GD and AIH. The patient was admitted to the Department of Pediatric Endocrinology, presenting with suspected hyperthyroidism. Clinical manifestations included ocular exophthalmos, tachycardia, reduced exercise tolerance, and motor restlessness. Initial laboratory assessments revealed mildly elevated transaminases, prompting further investigation. A primary diagnosis of GD was confirmed by relevant laboratory parameters. Antithyroid drugs (ATD) were administered, resulting in proper control of thyroid dysfunction. However, despite the gradual reduction of ATD, a further increase in hepatic biomarkers was observed and required a comprehensive diagnostic investigation, culminating in a liver biopsy. The findings of the biopsy yielded a definitive diagnosis of AIH.

Conclusions
In pediatric patients presenting with GD-associated liver dysfunction, AIH should be considered as a potential comorbidity, warranting vigilance in patients with hyperthyroidism and elevated transaminase levels.

keywords:

Graves’ disease and autoimmune hepatitis overlap syndrome with coincidental simultaneous presentation in a pediatric patient

Grażyna Waśka 1 , Katarzyna Gołąb-Jenerał 2 , Katarzyna Górowska-Kowolik 3 , Małgorzata Stojewska 3 , Agnieszka Zachurzok 3

autoimmune hepatitis, Graves’ disease, thyrotoxicosis

Grażyna Waśka

¹

,

Katarzyna Gołąb-Jenerał

²

,

Katarzyna Górowska-Kowolik

³

,

Małgorzata Stojewska

³

,

Agnieszka Zachurzok

³