Case report: silent thyroiditis developed during alpha-interferon therapy.
Alpha-interferon (IFN-alpha) was used for the treatment of chronic active hepatitis C in a 30-year-old woman who was euthyroid but had low titers of antithyroid antibodies before treatment. Two months after the initiation of IFN-alpha therapy she became thyrotoxic. She had nontender diffuse goiter. A laboratory examination revealed elevated levels of serum free thyroid hormones and a suppressed concentration of serum thyrotropin. Titers of antimicrosomal antibodies increased. The anti-thyrotropin receptor antibody was negative. A 99mTcO- scintigram of the thyroid showed reduced uptake. During the IFN therapy free thyroid-hormone levels started to decline. The IFN-alpha therapy was completed 1 month after the onset of thyrotoxicosis. Two months after the completion of the therapy the patient became euthyroid and 99mTcO- uptake was normalized. It is likely that preexisting chronic thyroiditis was exacerbated to cause silent thyroiditis during IFN-alpha therapy. None of the other 11 patients with chronic hepatitis C who had had no anti-thyroid antibodies and were treated with IFN-alpha showed anti-thyroid antibodies and thyroid dysfunction after the therapy. It is advisable to assess anti-thyroid antibodies and thyroid function in patients who are going to receive IFN-alpha treatment.
Kamikubo
K
K
Department of Internal Medicine, Takayama Red Cross Hospital, Japan.
Takami
R
R
Suwa
T
T
Kawase
Y
Y
Shiroko
J
J
Kametani
M
M
Tokimitsu
N
N
Sakata
S
S
D000328:Adult; D005260:Female; D006042:Goiter / Q000175:diagnosis / Q000209:etiology*; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects* / Q000627:therapeutic use; D011877:Radionuclide Imaging; D011994:Recombinant Proteins; D013667:Technetium; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000648:ultrastructure; D013966:Thyroiditis / Q000175:diagnosis / Q000209:etiology*; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood
D007370:Interferon Type I; D011994:Recombinant Proteins; D014284:Triiodothyronine; D013667:Technetium; D013974:Thyroxine