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Graves' hyperthyroidism showing transient hypothyroidism during interferon therapy for chronic hepatitis type C
Atsushi Inoue1, Shigeki Koizumi, Akira Matsuda
1Department of Internal Medicine, Kin-Ikyo Chuo Hospital, Sapporo, Japan.
Endocrine Journal
|July 12, 2005
Summary
Interferon therapy for hepatitis C can cause fluctuating thyroid function in patients with Graves' disease. This case shows a shift from hyperthyroidism to hypothyroidism and back, potentially due to changes in thyroid-stimulating and blocking antibodies.
Area of Science:
- Endocrinology
- Hepatology
- Immunology
Background:
- Graves' disease is an autoimmune disorder causing hyperthyroidism.
- Interferon (IFN) therapy is used for chronic active hepatitis C.
- Thyroid function and antibody levels were normal before IFN treatment in this patient.
Observation:
- A 43-year-old man developed hyperthyroidism four months into IFN therapy.
- He experienced a transient period of hypothyroidism, followed by recurrent hyperthyroidism.
- Thyroid-stimulating antibodies (TSAb) and thyroid-stimulation blocking antibodies (TSBAb) levels fluctuated significantly.
Findings:
- No characteristic changes in cytokines or soluble ICAM-1 were observed.
- The transient hypothyroidism may be attributed to a shift in the balance of TSH receptor antibodies (TRAb).
- Destructive thyroiditis complicating IFN therapy is another potential cause for the hypothyroid state.
Implications:
- IFN therapy can induce significant fluctuations in thyroid function in patients with pre-existing Graves' disease.
- Monitoring thyroid function and TRAb levels is crucial during IFN treatment.
- Understanding the interplay between IFN, autoimmune responses, and thyroid function is important for patient management.