title: Exacerbation of hypothyroidism following tumor necrosis factor-alpha infusion.
abstract: A 46-year-old woman with chronic thyroiditis who had been receiving thyroid hormone treatment for 10 yr developed severe hypothyroidism (FT4 0.37 ng/dl, FT3 1.38 pg/ml, TSH 151.00 microU/ml) following tumor necrosis factor-alpha (TNF) infusion for the treatment of a complicated cutaneous T-cell lymphoma. Indirect immunofluorescence staining of thyroid follicular cells showed aberrant expression of HLA class II antigens. The mechanisms underlying the exacerbation of the hypothyroidism may be an augmentation of immunological processes in the thyroid and a direct action of TNF on the synthesis and secretion of thyroid hormone.
authors.affiliation: First Department of Internal Medicine, School of Medicine, Kanazawa University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyakoshi
authors.forename: K
authors.initials: K
authors.lastname: Ohsawa
authors.forename: H
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Y
authors.initials: Y
authors.lastname: Nagai
authors.forename: Y
authors.initials: Y
authors.lastname: Ieki
authors.forename: Y I
authors.initials: YI
authors.lastname: Bando
authors.forename: K
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D005260:Female; D006681:HLA-D Antigens; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000209:etiology* / Q000276:immunology; D016410:Lymphoma, T-Cell, Cutaneous / Q000628:therapy; D008875:Middle Aged; D012878:Skin Neoplasms / Q000628:therapy; D013961:Thyroid Gland / Q000276:immunology; D013963:Thyroid Hormones / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects*
chemical_list: D006681:HLA-D Antigens; D013963:Thyroid Hormones; D014409:Tumor Necrosis Factor-alpha