LAUSR

antibody M2 sub-type (AMA-M2), anti-smooth muscle To the Editor: On March 9, 2018, a 31-year-old woman presentedwith liver dysfunction after thyroid cancer surgery. antibody (ASMA), anti-liver kidney microsomal antibody She was physically healthy; had no chronic diseases, such as hypertension and diabetes; had no history of infectious diseases, such as hepatitis and tuberculosis; had no history of drugs, food allergies, smoking, and alcohol consumption; and presented no obvious complaints during the disease course. B-ultrasound in the physical examination 3 years prior showed “left thyroid-occupying position.” On February 5, 2018, she had undergone surgery at our hospital. Laboratory findings on February 6, 2018 revealed white blood cells (WBCs) 9.06 10/L (3.50–9.50 10/L); neutrophils (NEs) 5.66 10/L (1.80–6.30 10/L); triiodothyronine (T3)0.94 (0.80–2.00)ng/mL; thyroxine (T4)6.4 (5.1–14.1) mg/dL; free T3 (FT3) 3.95 (3.10–6.80) pmol/L; free T4 (FT4) 15.57 (12.00–22.00) pmol/L; thyroidstimulating hormone (TSH) 2.56 (0.27–4.20) mU/L; thyroid peroxidase antibody (TPOAb) 8.2 (0–34.0) IU/mL; thyroglobulin antibody (TgAb)<10 ( 115) IU/mL; total bilirubin (T-BIL) 21.5 (5.0–22.0)mmol/L; direct bilirubin (D-BIL) 6.3 (0–10.2) mmol/L; alanine transaminase (ALT) 27.5 (7.0– 40.0) U/L; aspartate transaminase (AST) 22.7 (13.0–35.0) U/L; and alkaline phosphatase (ALP), 48.9 (35.0–100.0)U/L. Hepatitis C antibody, hepatitis B surface antigen, and hepatitis B core antibody immunoglobulinM tested negative. On February 7, 2018, intra-operative pathology during left thyroidectomy indicated micro-papillary carcinoma. On February 11, 2018, she was discharged and prescribed levothyroxine tablets A (LTA; Merck KGaA, Darmstadt, Germany)100 mgandcalciumcarbonateD3 tablets (CC-D3; Pfizer, China) 600 mg once daily.