ABASTRACT Hepatitis E (HEV) is an enterically-transmitted acute viral hepatitis which is caused by infection with hepatitis E virus. The illness often resembles that associated with other hepatotropic viruses and is usually self-limiting; in some cases, the disease progresses to acute liver failure. The infection is particularly severe in pregnant women. Patients with chronic liver disease and superimposed HEV infection can present with severe liver injury, the so-called acute-on-chronic liver failure. Chronic hepatitis E has been reported among immunosuppressed persons, in particular solid organ transplant recipients. We report here atypical clinical presentation of HEV case with extremely high liver enzyme in Grave``s disease.