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Treatment of interferon induced hypothyroidism symptoms –

Cancer 92 : — Substances Interferon-alpha.

David Stewart
Sunday, September 17, 2017
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  • PubMed Google Scholar.

  • However, in patients with positive TgAbs and TPOAbs, permanent hypothyroidism is more likely 29 and therefore levothyroxine withdrawal may not be indicated. The thyroid autoantibody pattern at the end of IFN therapy may be a reliable marker for the subsequent outcome of thyroid function

  • Conclusions Men with HCV infection treated with interferon and ribavirin should undergo routine screening for thyroid disease.

  • High prevalence of thyroid autoantibodies in a prospective series of patients with chronic hepatitis C before interferon therapy. Google Scholar.

IFN-Related Thyroid Disease: Epidemiological Aspects

Thus, thyroid disturbances will not remain undiagnosed. The first case presented as asymptomatic thyrotoxicosis within three months of therapy Figure 2A. Hepat Mon. Ward DLBing-You RG Autoimmune thyroid dysfunction induced by interferon-alfa treatment for chronic hepatitis C: screening and monitoring recommendations. J Gastroenterol Hepatol.

J Clin Endocrinol Metab 63 : — Bellentani HypothtroidismTiribelli C The spectrum of liver disease in the general population: lesson from the Dionysos study. Close mobile search navigation Article Navigation. Clin Endocrinol Oxf 56 : — Roti EUberti E Post-partum thyroiditis—a clinical update. J Hepatol 24 : 38 —

  • In the patients with TD, The thyroglobulin levels rose from

  • Lack of evidence for the Th2 predominance in patients with chronic hepatitis C.

  • In case 1, the pattern includes GD following thyroiditis that occurred during the treatment phase. Przegl Epidemiol.

  • However, population-based studies exclude a specific role of HCV infection in determining the development of thyroid disease 48 ,

  • Magnani, S. Medicine Baltimore.

Clin Exp Med 3 4 : — Among the study subjects, 4. Bini EJ, Mehandru Tretament. Wong, A. Any differences among the studied subgroups were determined using Student's t -test and one-way ANOVA for the normally distributed data, and the Mann-Whitney U, Wilcoxon, and Kruskal-Wallis tests were used for the non-normally distributed data.

Development of transient thyroid disease and reaction during treatment of chronic hepatitis C with interferon. Clin Microbiol Infect. This compound commonly induces both autoimmune and non-autoimmune thyroiditis. Download other formats More. The male-to-female ratio was 0. Endocrinol Metabol Clin North Am.

Publications

J Gastroenterol Hepatol. J Endocrinol Invest — A year-old woman presented for a routine review 8 weeks following her failed therapy with IFN- 2 for her chronic HCV.

Thus, thyroid disturbances will not remain undiagnosed. Endokrynol Pol. J Korean Med Sci 26 12 : — Journal overview.

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The annual incidence of TD cases was expressed as the number of cases with TD perperson-years. One innocent bystander in this accentuated response is the thyroid [7]. Accepted 15 Jul Although both hypothyroidism and hyperthyroidism were included, no specific mention was made of their timing or characteristics. Related articles. Her anti-Tg and anti-TPO titres were andrespectively. Our website uses cookies to enhance your experience.

Gov't Review. Thyroid 7 : — J Clin Endocrinol Metab 80 : — See Long-term outcome of interferon-alpha-induced thyroid autoimmunity and prognostic influence of thyroid autoantibody pattern at the end of treatment.

Background

Autoimmune thyroid diseases are common manifestations of hepatitis C infection, exacerbated by interferon-based treatment. Patient characteristics. McLachlan, and B. Magnani, S. A year-old woman presented for a routine review 8 weeks following her failed therapy with IFN- 2 for her chronic HCV.

In the untreated group, 2. Report of a WHO consultation symptoms in collaboration with the viral hepatitis prevention board, Antwerp, Belgium. Hypotuyroidism with HCV infection have lower lipid profiles [ 52 ]. Future studies to determine the optimal method and frequency of screening for thyroid dysfunction during HCV therapy and to evaluate the incidence and outcome of thyroid disease in HCV-infected patients treated with pegylated interferon in combination with ribavirin are needed.

Thyroid 12 : — Patients receiving interferon therapy should have their onterferon function monitored prior to and periodically during the course of interferon treatment. Thus, it is imperative to diagnose IFN-induced depression early, evaluate whether this depression is associated with IFN-induced anemia or thyroid dysfunction, which can be corrected, and if necessary treat with antidepressants. Clin Exp Immunol : 71 —

What are induced thyroid disorders?

Correlation of antithyroglobulin and antithyroid-peroxidase antibody profiles with clinical and ultrasound characteristics of chronic thyroiditis. Clin Exp Immunol : 71 — Biomed Pharmacother 53 : — J Clin Endocrinol Metab 70 : —

Braverman, E. New issue alert. Hepatology 26 : — J Hepatol 25 : — Gov't Review. Interferon alpha has been used to treat patients with cancer and patients with hepatitis C.

Myxedema and coronary artery disease--a comparative autopsy study. IIT appeared after 6. This intterferon was supported by a grant No. Additionally, thyroiditis induced by interferon is a substantial clinical problem for patients who are treated with IFN, with complications of thyrotoxicosis occurring in patients with severe or life-threatening complications [ 1738 ]. Thyroid —

Morisco et al. Endocrinol Metabol Induced hypothyroidism symptoms North Am. Consensus statement. Informed consent from the subjects was not obtained because there sympfoms no personal contact between the patients and the data collectors. J Hepatol — The addition of ribavirin to interferon-alpha therapy in patients with hepatitis C virus—related chronic hepatitis does not modify the thyroid autoantibody pattern but increases the risk of developing hypothyroidism.

IFNs: From Therapeutic Effectiveness to Untoward Effects

Patients with thyroid antibodies are at higher risk of developing interferon-associated thyroid dysfunction, and this risk persists in antibody positive patients even after completion of interferon therapy. It is not known whether iodine intake influences the occurrence of thyroid disease during IFN treatment. In some studies, treatment interferon beta has been associated with the development of both hypo and hyperthyroidism in about one third of all patients receiving the drug Eur J Endocrinol Oct; 4 Effect of 1-year treatment with interferon-beta1Effect of 1-year treatment with interferon-beta1b on thyroid function and autoimmunity in patients with multiple sclerosis. Thyrotoxicosis is frequently mild and transient without overt clinical manifestations and may be diagnosed only by obtaining frequent thyroid function tests, i. As many types of thyroid disease, particularly Hashimoto's disease and Grave's disease have an autoimmune basis, drugs such as interferon that produce effects on the immune system may also affect the course of autoimmune thyroid disease.

The spectrum of liver disease in the general population: lesson from intdrferon Dionysos study. J Clin Endocrinol Metab 80 : — Am J Med : — Am J Gastroenterol 89 : — Because destructive thyrotoxicosis is usually mild, it is likely that it will not be diagnosed clinically. Antidepressants have a number of risks and side effects that must be considered and may enter into the decision as to which antidepressant to choose. J Fr Ophthalmol 25 : —

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The effect of thyroid disorders on lipid levels and metabolism. Clin Endocrinol Oxf. The patient remained well and independent of thyroxine supplement in the following 12 months. Finally, the hypothyroivism in TT3 and TT4 levels during treatment may be related to the improvement of the hepatocellular lesions, as indicated by the reduction in ALT levels. George, and N. Most of the patients with thyroid dysfunction completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9 with subclinical thyroid disease.

Long-term interferon beta-1b therapy for MS: is routine thyroid assessment always useful? Antiviral treatment. Hepatology 26 : S—S. Roti EUberti E Post-partum thyroiditis—a clinical update. Autoimmunity 13 : 61 — Prevention of lymphocytic thyroiditis in iodide-treated non-obese diabetic mice lacking interferon regulatory factor

Hepatitis Interventional Therapy Group, Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. In the 12 patients with overt hypothyroidism, antithyroglobulin antibodies were present in 11 and antithyroid peroxidase antibodies were present in 10, whereas thyroid-stimulating immunoglobulins were present in 2 of the 3 individuals with overt hyperthyroidism. The other case showed an asymptomatic TSH increase 6. Expectoration of large bronchial casts secondary to the treatment of chronic hepatitis C with pegylated interferon and ribavirin. No goitre was detected nor were there any signs of thyrotoxicosis. Environ Hlth Perspect — A strength of this study was the large study population.

WHAT YOU NEED TO KNOW:

Some authors have reported complete recovery of thyroid function within a few months after IFN withdrawal 45 However, even years later thyroid autoantibodies may reappear However, the underlying autoimmune process usually persists.

View Article Google Scholar 4. However, Nagayama et al. Nagayama, H. Both treatment of interferon induced hypothyroidism symptoms liver and various nonhepatic tissues and organs may be affected during infection with HCV [ 12 ]. These may include gender and ethnicity, HCV viral factors, genetic predisposition, and environmental and patho-physiological factors among others. Color flow Doppler sonography rapidly differentiates type I and type II amiodarone-induced thyrotoxicosis. Contact us Submission enquiries: bmcendocrinedisorders biomedcentral.

Table 3 Risk factors associated with TD among patients with hepatitis C infection by univariate and multivariate Cox regression analyses Full size table. Interferon-induced thyroiditis IIT interfferon a major clinical problem for patients who receive IFN therapy, with complications like thyrotoxicosis being especially severe [9][10][11][12]. Study outcomes. Pre-existing thyroid autoimmunity can emerge as an important risk factor for developing thyroid dysfunction during IFN therapy. HCV infection may cause complex diseases with many etiologically unrelated symptoms; therefore, the concept of systemic HCV infection has emerged [ 123 ]. Arch Intern Med —

Publication types

Ann Intern Med — Bini EJ, Mehandru S. Interferon-induced thyroid dysfunction in chronic hepatitis C.

  • Akeno N, Tomer Y. A diagnosis of autoimmune hypothyroidism was made and consequently, thyroxine was started.

  • Clin Endocrinol Oxf.

  • The exogenous IFN- is believed to stimulate lymphocyte, macrophage and neutrophil function as well as increasing cytokine and chemokine concentrations, especially, interleukin-6 IL-6 [ 8 ]. The initial CDUS revealed heterogeneous isoechoic parenchyma and increased vascularization pattern IIIand the glandular volume was 8.

  • It is likely that the hepatitis C virus HCV itself plays a role in the disease, as the association between HCV infection and thyroiditis is well established.

Academic Editor: Paul M. The number of patients with a past history of hypertension, hyperlipidemia, diabetes, liver cirrhosis, chronic kidney disease CKDand goiter were One limitation of this study is the small number of patients, especially those who developed IIT. Of these, Health Sci J.

Gov't Review. A reevaluation of thyroid function should be carried out 4—6 wk after IFN has been discontinued, and if normal thyroid function returns or hypothyroidism develops and is treated with l -thyroxine, cytokine treatment could be resumed. Seeff LB Natural history of hepatitis C. Eur J Cancer Clin Oncol 24 : — Although isolated destructive thyrotoxicosis has been occasionally described, hypothyroidism often develops later as observed during the course of sporadic silent and postpartum and painful subacute thyroiditis. See Thyroid dysfunction during treatment of chronic hepatitis C with interferon alpha: no association with either interferon dosage or efficacy of therapy. As in other forms of destructive thyrotoxicosis, such as painful subacute thyroiditis and type II amiodarone-induced thyrotoxicosis, corticosteroid therapy might be efficacious 91 —

Teratment study found that patients with hyperlipidemia were at a higher risk for developing thyroid disorders. American Thyroid Association guidelines for detection of thyroid dysfunction. The relative risk of developing thyroid dysfunction, mainly hypothyroidism, was reported to betwo to 14 fold higher in patients with pre-existing positive TPO-Ab, as compared to patients with negative antibodies [9][29]. Study design.

International Journal of Endocrinology

Clin Exp Immunol : — IFN-induced depression is highly responsive to antidepressants with benefits occurring frequently at relatively low doses and after only a few weeks. Google Scholar Crossref. Several clinical aspects are encountered including hypothyroidism the most frequent depending on the series and hyperthyroidism related to Graves' disease.

Hum Pathol Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Three patients were not treated hypothyrroidism levothyroxine because hypothyroidism was diagnosed at the end of HCV treatment. Doi, S. Pharmacological treatment of hypertension and hyperlipidemia in Izhevsk, Russia. Functional TB-Ab assay would have been definitive but unfortunately was not available. Aftermath of IFN Withdrawal Several studies have put forth contradictory results regarding the reversibility of the effect of IFN therapy on thyroid function after withdrawal of the treatment.

Abstract Background Thyroid dysfunction is the inducev endocrinopathy associated with HCV infection due to interferon-based treatment. A higher prevalence of thyroid disorders has been reported in HCV-infected patients than in the general population [8]. Her vital signs were satisfactory, with normal tendon reflexes and no goitre. These other factors include HCV viral factors, genetic predisposition, environmental factors, and patho-physiological factors. We confirmed the existence of two main forms of IIT autoimmune and non-autoimmune. Paris, 26—27 February Ridgway, Y.

Am J Med : — JAMA 8 : — hypothyroidis, On the basis of known and effective treatment strategies, IFN-induced depression should not be an obstacle for continued treatment in most patient populations. The thyroid autoantibody pattern at the end of IFN therapy may be a reliable marker for the subsequent outcome of thyroid function

View at: Google Scholar V. Long-term outcomes and risk factors of thyroid dysfunction during pegylated interferon and ribavirin treatment in patients with interferon induced hepatitis C infection in Taiwan. Patients with genotypes 2 or 3 were treated for 24 weeks, whereas those with genotype 1 were treated for up to 48 weeks. The lipid parameters and lipoprotein a excess in Hashimoto thyroiditis. Hepatitis C virus infection in Taiwan: past, present, and future. J Clin Endocrinol Metab —

The excessive release of thyroid hormones by the damaged thyroid follicles is responsible for the occurrence of thyrotoxicosis similar to that observed in subacute, postpartum, and sporadic silent thyroiditis 71 — Clin Exp Immunol : 71 — In the case of vulnerable patients e. Hepatology 18 : — Related articles in Web of Science Google Scholar.

The effect of thyroid disorders on lipid levels and metabolism. View Article Google Scholar. Related articles. Such modifications persisted during CDUS performed 8. View Article Google Scholar 5.

Ward DLBing-You RG Autoimmune thyroid dysfunction induced by interferon-alfa treatment for chronic hepatitis C: screening and monitoring recommendations. Prediction of interferon-alpha—induced thyroid dysfunction in patients with chronic hepatitis C. Pegylated interferon-alpha2beta in combination with ribavirin does not aggravate thyroid dysfunction in comparison to regular interferon-alpha2beta in a hepatitis C population: meta-analysis. Sign in to make a comment Sign in to your personal account. Ann Acad Med Singapore. From 16 studies and patients, the overall frequency of occurrence of newly developed Tab during IFN therapy was Lancet ; 87 Google Scholar Crossref.

N Engl J Med. An earlier study [22] conducted on patients undergoing IFN alpha therapy for chronic HCV and with no interferon induced hypohhyroidism pre-existing thyroid disease did not report any thyroid autoantibodies after IFN treatment. Most of the patients with thyroid dysfunction completed HCV therapy, and thyroid disease resolved in 10 of the 12 patients with overt hypothyroidism, 2 of the 3 with overt hyperthyroidism, and all 9 with subclinical thyroid disease. The thyroglobulin levels rose from Incidence of side effects during therapy with different types of alpha interferon: a randomised controlled trial comparing recombinant alpha 2b versus leukocyte interferon in the therapy of naive patients with chronic hepatitis C. IFN therapy has shown to have direct toxic effect on thyroid cells, resulting in thyrocyte apoptosis, rupture of follicles and release of thyroid hormones [79].

Publication types Research Support, N. Am J Gastroenterol 95 : — Abstract Interferon IFN is a pro-inflammatory cytokine that is widely used for the treatment of a number of disorders including viral infections, hematological proliferative disorders, and skin malignancies. Clin Endocrinol Oxf 50 : 95 — Email alerts Article activity alert.

Temporal relationship between the appearance of hypothuroidism autoantibodies and development of destructive thyroiditis in patients undergoing treatment with two different type-1 interferons for HCV-related chronic hepatitis: a prospective study. It is likely that the hepatitis C virus HCV itself plays a role in the disease, as the association between HCV infection and thyroiditis is well established. Antidepressants have a number of risks and side effects that must be considered and may enter into the decision as to which antidepressant to choose. A reevaluation of thyroid function should be carried out 4—6 wk after IFN has been discontinued, and if normal thyroid function returns or hypothyroidism develops and is treated with l -thyroxine, cytokine treatment could be resumed.

View Article Google Scholar 4. Subclinical hypothyroidism resolved spontaneously in all 6 patients after completion of HCV therapy. The first case presented as asymptomatic thyrotoxicosis within three months of therapy Figure 2A. There were no significant differences between the treated and nontreated groups with respect to age, sex, past history of hyperlipidemia and goiter.

Endocrine evaluation in patients treated with interferon-alpha for chronic hepatitis C. Korean Association for the Study of the Liver. Post et al. Patients who developed overt thyroid disease were significantly more likely to self-report a family history of thyroid disease in a first-degree relative than those without thyroid dysfunction

To conclude, the present review shows that there is a treatmejt range in the incidence of newly developed thyroid dysfunctions and thyroid antibodies in IFN-treated HCV patients. Correspondence to Kow-Tong Chen. Figures 2 Tables 1. Get free access to newly published articles. The study also analyzes the pre-disposing factors that may cause thyroid dysfunctions in HCV patients.

  • J Endocrinol Invest —

  • Horm Res 44 : — J Intern Med : —

  • Our series demonstrates a wide spectrum of autoimmune thyroid diseases, ranging from GD to thyroiditis to profound subclinical hypothyroidism following IFN treatment.

  • Arch Intern Med : — Magrassi and A.

  • Tomer, and S. The proposed hypotheses for the development of the full spectrum of thyroid diseases after the completion of combination IFN-based therapy.

Aymptoms were no significant differences between the treated and nontreated groups with respect to age, sex, past history of hyperlipidemia and goiter. Arch Intern Med — However, a population-based study excluded a specific role of HCV infection in determining the development of thyroid disease [38]. Sherman, and Y. Treatment was continued for 12 months during which his thyroid function tests were normal.

Mazziotti, F. Dusheiko G Side effects of alpha interferon in chronic hepatitis C. Browse Subject Areas? Woeber KA Update on the management of hyperthyroidism and hypothyroidism. Total T4 levels were also reduced at 3 and 12 months, but free T4 and thyroid stimulating hormone TSH levels remained stable.

They are produced and secreted inducde cells in response to viral infections or to various synthetic and biological inducers 7. Patients receiving interferon therapy should have their thyroid function monitored prior to and periodically during the course of interferon treatment. Hepatology 36 : S — S Treatment of type II amiodarone-induced thyrotoxicosis by either iopanoic acid or glucocorticoids: a prospective, randomized study.

Interferon induced 13 : — Oxford Academic. Ribavirin polarizes human T cell responses toward a type 1 cytokine profile. The duration of destructive thyrotoxicosis is variable, ranging from a few weeks to a few months. Arch Intern Med Jul 13; 13 Increased risk of autoimmune thyroid disease in hepatitis C vs hepatitis B before, during, and after discontinuing interferon therapy and Thyrotoxicosis induced by alpha-interferon therapy in chronic viral hepatitis. Withdraw IFN until thyroid function normalizes after radioiodine therapy. A genetic predisposition to thyroid autoimmune disease is probably necessary for the development of thyroid disease in patients treated with IFN 27 —

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If Treatment of interferon induced hypothyroidism symptoms induces a depression in a patient with a bipolar disorder history, hypothyroudism treatment must include a mood stabilizer. J Hepatol 24 : 38 — The stimulation of cytotoxicity is mainly due to an up-regulation of perforin expression in peripheral natural killer and T cells 13very likely sustained by suppression of T helper Th 2 and an increase in Th1 immune response 14 — Furthermore, IFN has direct inhibitory effects on thyroid hormone synthesis, release, and metabolism 24 — Nevertheless, the remarkable variation in the prevalence of IFN-related thyroid disease may also reflect variable individual predisposition to the disease. J Clin Endocrinol Metab 63 : —

The frequency of newly developed Tab during IFN treatment in combination therapy was in the range between 0— IFN treatment may also induce a subtle defect in the thyroidal organification of iodide, thus further impairing hormone synthesis [9]. Her vital signs were satisfactory, with normal tendon reflexes and no goitre. Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial. Interferon-induced thyroiditis in the hypothyroid phase was unlikely given that there was no hyperthyroid phase. J Viral Hepat. Hence the overall frequency of thyroid dysfunctions and newly developed Tabs reported as side effects of mono and combination therapy of IFN in HCV patients from different studies in this systematic review analysis may have limitations of factors mentioned above.

Hepatol Int. Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha. Abrir menu Brasil. Gastroenterology ; PubMed Google Scholar. Therefore, HCV patients may carry a predisposition to autoimmune reactions through the mechanism of molecular mimicry [28].

Because of these problems, definitive treatment of hyperthyroidism with radioiodine or intsrferon thyroidectomy symptoms by levothyroxine substitutive treatment may be an appropriate option 96especially if the patient requires continued or reinstitution of IFN. J Clin Endocrinol Metab. It is not known whether iodine intake influences the occurrence of thyroid disease during IFN treatment. Clin Endocrinol Oxf 50 : 95 — Citing articles via Web of Science Skip Nav Destination Article Navigation. J Endocrinol Invest 20 : 24 —

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Interferon alpha has also been associated with the development of thyroid inflammation, and either hypo or hypothyroidism which commonly improves following discontinuation of interferon therapy. Destructive thyrotoxicosis usually occurs in the first weeks of IFN treatment of interferon induced hypothyroidism symptoms in close temporal relationship with the appearance of thyroid autoantibodies, especially thyroglobulin antibodies TgAbs Google Scholar Crossref. Abstract Interferon IFN is a pro-inflammatory cytokine that is widely used for the treatment of a number of disorders including viral infections, hematological proliferative disorders, and skin malignancies. The excessive release of thyroid hormones by the damaged thyroid follicles is responsible for the occurrence of thyrotoxicosis similar to that observed in subacute, postpartum, and sporadic silent thyroiditis 71 — J Intern Med : —

Our previous published data suggested that thyroid surveillance is carried out monthly during treatment [ 7 treatment of interferon induced hypothyroidism symptoms, although the frequency of interferoj remains contentious and the National Academy of Biochemistry is yet to recommend thyroid testing in this clinical scenario [ 22 ]. All of these individuals achieved sustained virological response SVR whereas only 1 of our 3 cases did not. Correspondence: Edmund J. Academic Editor: Paul M. However, our study had several limitations.

View at: Google Scholar V. Socioeconomic factors e. Reddy, W. Methods The patients underwent clinical and hormonal evaluations before treatment and every 12 weeks during treatment.

Thyroid autoimmunity in patients on long term therapy with leukocyte-derived interferon. Publication types Review. Correlation of antithyroglobulin and antithyroid-peroxidase antibody profiles with clinical and ultrasound characteristics of chronic thyroiditis. As in other forms of destructive thyrotoxicosis, such as painful subacute thyroiditis and type II amiodarone-induced thyrotoxicosis, corticosteroid therapy might be efficacious 91 —

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Kakizaki, H. This biological relationship may explain the impact of hypothyroidism, which is often linked to excess TC and low-density lipoprotein cholesterol LDL-C [ 50 ]. Despite its success in treating HCV infection, the association between HCV infection treatment and thyroid disorders has made the treatment controversial. Pathophysiological factors. For example, if a patient developed TD several years after the completion of treatment, should this case be classified as related to the treatment with interferon or not?

All of these individuals achieved sustained induced hypothyroidism symptoms response SVR whereas only 1 of our 3 cases did not. Friedrich-Rust M, Theobald J, Zeuzem S, Bojunga J Hypothyeoidism function and changes in ultrasound morphology during antiviral therapy with pegylated interferon and ribavirin in patients with chronic hepatitis C. Dig Dis Sci — However, the observation strongly suggests a persisting and disrupted immune system. High prevalence of thyroid autoantibodies in a prospective series of patients with chronic hepatitis C before interferon therapy. All study subjects who met the definition of a case patient before the index date were excluded.

Advance article alerts. The importance of this disorder is emphasized by the fact that 1. Clin Endocrinol Oxf 39 : —

J Hepatol 25 : — Ijduced of these effects, IFNs have been widely used in the treatment of neoplastic, viral, and autoimmune diseases. Am J Gastroenterol 95 : — Ultrasound evaluation of the thyroid gland, especially if performed with the auxiliary application of a quantitative computerized analysis 7475shows a diffuse hypoechogenicity accompanied sometimes by reduced vascularity color flow Doppler as observed in other types of destructive thyroiditis

  • BMC Cardiovasc Disord.

  • Google Scholar PubMed. For this reason, the relapse of circulating thyroid antibodies has occurred several years after IFN has been discontinued

  • The incidence of thyroid dysfunction in our patients was higher than the 3.

  • The critical point is to understand how a generalized activation of the immune system, induced by the cytokine treatment, may result in an organ-specific involvement of the thyroid gland.

Chung Treatment of interferon induced hypothyroidism symptoms YK Development of thyroid autoimmunity after administration of recombinant human interferon-alpha 2b for chronic viral hepatitis. At each visit, the presence and severity of adverse events were assessed and routine laboratory testing was performed. Subclinical hyperthyroidism resolved spontaneously in all 3 patients after completion of HCV therapy. Health Sci J. These may include gender and ethnicity, HCV viral factors, genetic predisposition, and environmental and patho-physiological factors among others.

Cytokine symphoms : — J Endocrinol Invest 20 : 24 — Hoofnagle JH Course and outcome of hepatitis C. Receive exclusive offers and updates from Oxford Academic. Although isolated destructive thyrotoxicosis has been occasionally described, hypothyroidism often develops later as observed during the course of sporadic silent and postpartum and painful subacute thyroiditis.

Finally, euthyroid patients with symptlms previous episode of IFN-induced thyroid dysfunction are prone to develop altered thyroid function when exposed to excess iodine Clin Endocrinol Oxf 59 : — J Intern Med. IFN may then be resumed. It is noteworthy that the immune activation induced by IFNs, as well as ribavirin, does not involve just the virus-specific immune response but a generalized activation of the immune system, predisposing to the development of untoward events in addition to the therapeutic effects

  • These findings have been noted by other investigators and suggest that combination therapy for HCV can be continued, even in those who develop overt thyroid disease. Similar to the findings in the previous study [ 29 ], we found that the TDs identified among patients with HCV infection were hypothyroidism

  • IFN-induced depression is highly responsive to antidepressants with benefits occurring frequently at relatively low doses and after only a few weeks.

  • Vascularization was classified according to Bogazzi et al.

  • Niwa, S. Jagger, J.

  • Gubertini, C. Any patients with HBV infections, those who were pregnant, and those who were using amiodarone or lithium were excluded.

Sign In or Create an Account. Am J Med : — See Long-term outcome of interferon-alpha-induced thyroid symptoms and prognostic influence of thyroid autoantibody pattern at the end of treatment. In the case of vulnerable patients e. J Hepatol 35 : — N Engl J Med : — The role of iodine in thyroid autoimmunity: from chickens to humans—a review.

Clinical examinations, hormonal evaluations, and color-flow Doppler ultrasonography of the thyroid were performed interferpn and during antiviral therapy. J Gastroenterol Hepatol. Myxedema and coronary artery disease--a comparative autopsy study. At each visit, the presence and severity of adverse events were assessed and routine laboratory testing was performed. During the study period, 4.

J Immunol : — Clin Endocrinol Oxf 56 : — Evolution of thyroid autoimmunity during iodine prophylaxis—the Sri Lankan experience. J Clin Endocrinol Metab 63 : — Select Format Select format.

Thyrotoxicosis is frequently mild and transient without overt clinical manifestations and may be diagnosed only by obtaining frequent thyroid function tests, i. Although it is uncertain whether TPOAbs have a major pathophysiological role in inducing hypothyroidism 83it has been suggested that these antibodies reflect a more advanced and aggressive underlying autoimmune destructive process of the thyroid gland 2984 — New York: Marcel Dekker, in press. Furthermore, IFN has direct inhibitory effects on thyroid hormone synthesis, release, and metabolism 24 — Issue Section:. Publication types Review.

  • However, only the former specifies that thyroid function testing is recommended at each treatment visit, rather than monthly.

  • Advanced Search. Women are more susceptible than men to develop IFN-related thyroid disease, having a relative risk 3- to 7-fold higher as reported in some 373840 — 42 but not all studies 2743 —

  • Bini EJ, Mehandru S.

  • The annual incidence of TD cases was expressed as the number of cases with TD perperson-years.

  • Autoimmunity 13 : 61 — Permissions Icon Permissions.

However, in patients with positive TgAbs and TPOAbs, permanent hypothyroidism is more likely 29 and therefore levothyroxine withdrawal may not be indicated. Subacute thyroiditis during treatment with combination therapy interferon plus ribavirin for hepatitis C virus. Email alerts Article activity alert. Clin Endocrinol Oxf 43 : 55 —

In addition, FT 3 and FT 4 levels were obtained at the time of diagnosis in all 3 patients, and the levels were elevated in all 3 individuals. The high IL-6 is also thought to block TSH-mediated iodine uptake leading to the absent uptake scan [ 10 ]. There was a wide range in the incidence of newly developed thyroid dysfunctions and thyroid antibodies in HCV patients during IFN treatment both single and combination. See text for detailed discussions. This paper suggests the need to continue thyroid surveillance in IFN-treated HCV patients following the completion of therapy, perhaps for the first 6 months.

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