الفهرس 
The Thyroid GlandOnly 14 pages are availabe for public view
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Abstract
The great majority of patients with acute hepatitis C develop chronic HCV infection. It can ultimately result in liver cirrhosis, hepatic failure (portal hypertension, ascites, and encephalopathy) or hepatocellular carcinoma.
Porto systemic encephalopathy is considered as a serious complication of chronic liver disease and is broadly defined as an alteration in mental status and cognitive function occurring the presence of liver failure .
Liver plays an important role in the metabolism of thyroid hormones, as it is the most important organ in the peripheral conversion of tetraiodothyronine (T4) to triiodothyronine (T3) by type I iodinase resulting to 5 deiodination of T4.Moreover, it is involved in conjugation and circulation of thyroid hormones by synthesis of thyroid binding protein.
It was found that the decrease level of total T3 reflect severity of liver cell failure and hepatic encephalopathy (Vezali et al., 2009).
Some studies reported that there is a correlation between serum levels of tT3 and liver cirrhosis.
This study was designed to assess the association between tT3 and severity of liver cirrhosis according to Child score and MELD score.
It was held in Gastroentrology and hepatology departement, Maadi Military Hospital.
For better assessment, this study included number of (45) cases. They were divided into main three groups; Group I:Included 15 patients with Child Pugh classification A, Group II: Included 15 patients with Child Pugh classification B, Group III: Included 15 patients with Child Pugh classification C.
All the studied cases were subjected to the following: careful medical history taking, full physical examination, The Child-Pugh & MELD were calculated and laboratory investigations including :CBC, ESR, liver function tests, kidney function tests, serum electrolytes, abdominal ultrasonography and tT3 and in case of any abnormalities, complete thyroid profile will be done for them.
Our results revealed that there is a strong statistically significant negative correlation between Total T3 level and both Child Pugh score and MELD score.
We found that the tT3 good marker of severity of liver cirrhosis, as tT3 was exhibited good ability to predict the presence of Ascites with sensitivity = 92.3% and specificity= 81.2%, exhibited excellent ability to predict coma where sensitivity = 97.3% and specificity= 100% and excellent ability to predict prolonged INR ≥ 1.7 where sensitivity = 96.4% and specificity= 99.88%.