Thyroid Disease and Alkaline Phosphatase

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To the editor: Following the recent reports in your journal of raised alkaline phosphatase levels in patients with subacute thyroiditis (1–4), I wish to report an additional case in which initial liver function test findings were normal. I also wish to report a case of thyrotoxicosis in which liver function test findings have remained abnormal for 9 months.

A 38-year-old woman presented with a 2-week history of painful swelling of her thyroid gland, which on examination was tender. Investigations (see Table 1) were essentially normal apart from an elevated erythrocyte sedimentation rate and serum thyroxine. She was treated with indomethacin.

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