Graves' disease in interferon-alpha-treated and untreated patients with chronic hepatitis C virus infection.
An association between Graves' disease (GD) and chronic hepatitis C (C-HC) has been observed both in the presence and the absence of recombinant interferon-alpha (rIFN-alpha) treatment. rIFN-alpha-induced GD is characterized by suppressed thyroid-stimulating hormone levels; normal or elevated free triiodothyronine (FT3) and free thyroxine (FT4) values; the presence of thyroid peroxidase antibodies, antithyroglobulin antibodies, and thyroid receptor antibodies; and high iodine thyroid uptake. In contrast, GD developed during C-HC without rIFN-alpha is less clearly defined. In this study, we examined two groups of patients: group A, 28 patients with C-HC treated with rIFN-alpha who developed GD after 1 to 9 months, and group B, 10 patients with C-HC who developed GD without a previous rIFN-alpha treatment. At the time of GD, both groups started methimazole therapy; thyroid function was reevaluated after 3, 6, 9, and 12 months. Group A patients continued IFN. After 12 months, all patients of group A were euthyroid, and 21 of them (75%) had already stopped methimazole treatment, whereas all patients of group B were euthyroid and only 2 (20%) had stopped methimazole. In conclusion, the data show a better course of GD, with a more precocious and significantly higher number of recoveries in patients with rIFN-alpha-induced GD than in rIFN-alpha-unrelated disease. Further studies are needed to establish whether the two types of GD differ not only from a clinical point of view but also because of different underlying pathogenetic mechanisms.
Minelli
Roberta
R
Cattedra di Endocrinologia, Università degli Studi di Parma, Parma, Italy. roberta.minelli@unipr.it
Coiro
Vittorio
V
Valli
Maria Antonietta
MA
Finardi
Lorenzo
L
Di Seclì
Clelia
C
Bertoni
Roberto
R
La Gioia
Daniele
D
Barilli
Angela Luciana
AL
Ferrari
Carlo
C
Jotti
Gloria Saccani
GS
Delsignore
Roberto
R
D000998:Antiviral Agents / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use*; D007453:Iodide Peroxidase / Q000097:blood; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D008875:Middle Aged; D011988:Receptors, Thyroid Hormone / Q000276:immunology; D011994:Recombinant Proteins; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000032:analysis; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000032:analysis
D000998:Antiviral Agents; D001323:Autoantibodies; D007370:Interferon Type I; D011988:Receptors, Thyroid Hormone; D011994:Recombinant Proteins; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D008713:Methimazole; D013972:Thyrotropin; D007453:Iodide Peroxidase; D013974:Thyroxine