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Arch Intern Med (Chic). 1932;50(5):721-729. doi:10.1001/archinte.1932.00150180074005.
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Jaundice is an unusual complication of exophthalmic goiter. Isolated cases have been reported from time to time, and have been collected by Sattler.1 Assmann2 has more recently reviewed the subject and added his experience. Clinical evidence of disturbance of the liver in hyperthyroidism is offered by occasional cases with frank jaundice. In most instances, icterus is unrelated to the disease and is merely the result of an intercurrent complication, such as catarrhal jaundice,3 cholelithiasis,4 syphilis,5 cholangitis or other infections.6 Cardiac decompensation and associated factors7 may account for the appearance of icterus in the terminal stages of exophthalmic goiter. (In two cases of terminal jaundice complicating thyrocardiac disease observed by me, the jaundice was explained on the basis of cholangitis demonstrated histologically.) Occasionally, however, the jaundice can be explained only as a direct influence of the thyroid intoxication on the liver cells.8 In fact, exteme instances occur in which


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