[Autoimmune functional disorders of the thyroid during interferon-beta-1b treatment in patients with multiple sclerosis. Case report and literature review].
Occurrence of thyroid autoimmunity and dysfunction following interferon alpha treatment of viral hepatitis and other diseases are known adverse effects and have been ascribed to the cytokine's general immunomodulatory and -activating properties. However, in spite of its extensive application, there have been few reports of such incidents during interferon beta (IFN-beta-1a/b) therapy, which is considered the standard treatment of relapsing-remitting multiple sclerosis (MS), and prospective studies have been published only recently. Here we present the case of a 38-year-old woman with Graves' disease including massive thyroid-associated ophthalmopathy appearing de novo following IFN-beta-1b therapy for MS. A literature search revealed an 11% (5% clinically overt) overall incidence of de novo thyroid dysfunction in IFN-beta-treated MS patients, mostly autoimmune hyperthyroidism. (Large-scale comparative studies for IFN-beta-1a are not available at present). Specific treatment but not necessarily discontinuation of IFN-beta-1b therapy was required in most cases. Female gender, pre-existing thyroid autoimmunity, and family history of thyroid disorders are presumable risk factors for thyroid dysfunction de novo during IFN-beta-1b treatment.
Lange-Asschenfeldt
C
C
Klinik und Poliklinik für Neurologie, Klinikum, Johannes-Gutenberg-Universität, Mainz. lange@medscape.com
Boor
S
S
Kahaly
G J
GJ
Thömke
F
F
D000328:Adult; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D006111:Graves Disease / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy*; D016896:Treatment Outcome
D000068576:Interferon beta-1b; D016899:Interferon-beta