Autoimmune thyroiditis and myelosuppression following treatment with interferon-alpha for hepatitis C.
METHODS
We describe the case of a 48-year-old woman from Thailand diagnosed with chronic hepatitis C, who experienced a suppression of all blood cell counts accompanied by a newly developed clinically manifested autoimmune thyroid disorder after treatment with interferon alpha-2b (INF-alpha) 46 days after beginning of therapy a decrease of platelet, red and white blood cell counts became obvious. Concomitantly we observed an increase of FT4 and FT3 with a totally depressed TSH level 80 days after starting INF-alpha administration. Antibody assessment resulted in detection of high numbers of antithyroid-microsomal antibodies and antithyroglobulin antibodies. Thyroid hormone levels normalized under treatment with methimazole/propylthiouracil within 4.5 months. However, two months after cessation of antithyroid therapy increasing TSH levels and decreasing FT4 levels indicated a new tendency towards a hypothyroid state.


CONCLUSIONS
We classify this case as an interferon-alpha-induced disorder of thyroid function accompanied by myelosuppression. A close monitoring for thyroid dysfunction, e.g. evaluation of TSH-levels before and after administration of INF-alpha is mandatory.
Schmitt
K
K
Philipp Klee-Institute of Clinical Pharmacology, Klinikum Wuppertal, University of Witten/Herdecke, Germany.
Hompesch
B C
BC
Oeland
K
K
von Staehr
W G
WG
Thürmann
P A
PA
D001327:Autoimmune Diseases / Q000139:chemically induced*; D005260:Female; D019698:Hepatitis C, Chronic / Q000628:therapy*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D007165:Immunosuppression Therapy; D016898:Interferon-alpha / Q000009:adverse effects*; D008875:Middle Aged; D013966:Thyroiditis / Q000139:chemically induced* / Q000276:immunology; D013972:Thyrotropin / Q000097:blood
D018828:Immunoglobulins, Thyroid-Stimulating; D016898:Interferon-alpha; D013972:Thyrotropin