[Natural history of dysthyroidism during interferon treatment of chronic hepatitis C].
Thyroid dysfunction developed in 35 patients among a series of 300 (190 men and 110 women) treated with alpha-interferon (35/300 = 12%. No relationship was observed between the type of alpha-interferon, the dose, or hepatic response, but there were more women (24/35). Antithyroid antibody levels were frequently elevated before treatment (8/35, 23%). Hypothyroidism developed in 27 patients, 7 with clinical hypothyroidism, 10 with moderate hypothyroidism and 5 with elevated TSH only. Patients with severe symptoms and highly elevated thyroid antibodies were more prone to develop sustained or irreversible hypothyroidism (10 patients). Twelve patients recovered a normal thyroid function within a few months, but antibody levels fell more slowly. Primary hyperthyroidism of variable severity appeared in 13 patients. In 8 patients, normal thyroid function was recovered within a few weeks but thyroid antibodies remained high for at least one year. In 5 others spontaneous hypothyroidism occurred within a few weeks ("biphasic" hypothyroidism). Direct toxicity appears to be less probable than an autoimmune mechanism; elevated antithyroid antibodies were observed in only 20 patients (57%). In clinical practice, TSH levels should be regularly monitored during and after alpha-interferon therapy.
Mekkakia-Benhabib
C
C
Service de Médecine Nucléaire, Hôpital Beaujon, Clichy.
Marcellin
P
P
Colas-Linhart
N
N
Castel-Nau
C
C
Buyck
D
D
Erlinger
S
S
Bok
B
B
D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced* / Q000276:immunology; D007037:Hypothyroidism / Q000139:chemically induced* / Q000276:immunology; D007370:Interferon Type I / Q000009:adverse effects / Q000627:therapeutic use; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology; D011994:Recombinant Proteins; D013954:Thyroglobulin / Q000276:immunology
D000906:Antibodies; D000998:Antiviral Agents; D007370:Interferon Type I; D016898:Interferon-alpha; D011994:Recombinant Proteins; D013954:Thyroglobulin; D009195:Peroxidase