Vol 63, No 1 (2012)
Review paper
Submitted: 2013-02-15
Published online: 2012-02-29
Interferon-induced thyroiditis during treatment of chronic hepatitis C
Dorota Kozielewicz, Waldemar Halota
Endokrynol Pol 2012;63(1):66-70.
Vol 63, No 1 (2012)
Reviews — Postgraduate Education
Submitted: 2013-02-15
Published online: 2012-02-29
Abstract
Thyroid function disorders affect between 5% and 15% of patients treated with IFNα and RBV for chronic hepatitis C. Women and patients with thyroid peroxidase antibodies (TPOAb) found before the treatment are at risk of developing the disorders (46.1% vs. 5.4%). The spectrum of IFNα-induced thyroiditis (IIT) includes two groups. Disorders with an autoimmune background are: presence of thyroid autoantibodies without clinical disease, Hashimoto’s disease and Graves’ disease. The second group comprises diseases caused by the
direct toxic effect of IFNα on the thyroid gland, i.e. destructive thyroiditis and non-autoimmune hypothyroidism. Thyroid diseases are
not an absolute contraindication for IFNα and RBV therapy. In patients diagnosed with thyroid dysfunction, before the antiviral therapy it is necessary to achieve euthyreosis. Thyroid function disorders may occur at any moment of the therapy. The earliest have been observed in the 4th week of treatment, and the latest 12 months after its termination. During the therapy, in order to diagnose IIT early, it is recommended to determine TSH level every 2–3 months depending on the presence of TPOAb before the treatment. The diagnosis and treatment of thyroid function disorders should be conducted in co-operation with an endocrinologist.
Abstract
Thyroid function disorders affect between 5% and 15% of patients treated with IFNα and RBV for chronic hepatitis C. Women and patients with thyroid peroxidase antibodies (TPOAb) found before the treatment are at risk of developing the disorders (46.1% vs. 5.4%). The spectrum of IFNα-induced thyroiditis (IIT) includes two groups. Disorders with an autoimmune background are: presence of thyroid autoantibodies without clinical disease, Hashimoto’s disease and Graves’ disease. The second group comprises diseases caused by the
direct toxic effect of IFNα on the thyroid gland, i.e. destructive thyroiditis and non-autoimmune hypothyroidism. Thyroid diseases are
not an absolute contraindication for IFNα and RBV therapy. In patients diagnosed with thyroid dysfunction, before the antiviral therapy it is necessary to achieve euthyreosis. Thyroid function disorders may occur at any moment of the therapy. The earliest have been observed in the 4th week of treatment, and the latest 12 months after its termination. During the therapy, in order to diagnose IIT early, it is recommended to determine TSH level every 2–3 months depending on the presence of TPOAb before the treatment. The diagnosis and treatment of thyroid function disorders should be conducted in co-operation with an endocrinologist.
Keywords
interferon alpha; chronic hepatitis C; interferon-induced thyroiditis; thyroid autoantibodies
Title
Interferon-induced thyroiditis during treatment of chronic hepatitis C
Journal
Endokrynologia Polska
Issue
Vol 63, No 1 (2012)
Article type
Review paper
Pages
66-70
Published online
2012-02-29
Page views
632
Article views/downloads
2337
Bibliographic record
Endokrynol Pol 2012;63(1):66-70.
Keywords
interferon alpha
chronic hepatitis C
interferon-induced thyroiditis
thyroid autoantibodies
Authors
Dorota Kozielewicz
Waldemar Halota
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