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Thyroid dysfunction during interferon alpha therapy for chronic hepatitis C.

Lily Shen1, Chuong Bui, Robert Mansberg

  • 1Department of Nuclear Medicine, Nepean Hospital, Penrith, New South Wales, Australia. lshen@bigpond.com

Clinical Nuclear Medicine
|July 19, 2005
PubMed
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Interferon-alpha therapy can cause thyroid dysfunction. This case report details a patient experiencing two distinct forms of hyperthyroidism, subacute thyroiditis and Graves disease, during antiviral treatment for hepatitis C.

Area of Science:

  • Endocrinology
  • Hepatology
  • Pharmacology

Background:

  • Interferon-alpha (IFN-α) therapy is a known cause of various thyroid dysfunctions.
  • Hepatitis C virus (HCV) infection is often treated with IFN-α and ribavirin.

Observation:

  • A 22-year-old woman with chronic hepatitis C presented with hyperthyroidism during IFN-α and ribavirin treatment.
  • Initial Tc-99m thyroid scintigraphy showed low uptake, indicative of subacute thyroiditis.
  • A second episode of hyperthyroidism occurred 10 months later, with scintigraphy revealing increased uptake consistent with Graves disease.

Findings:

  • The patient experienced two distinct types of interferon-alpha-induced hyperthyroidism: subacute thyroiditis followed by Graves disease.
  • Both conditions were confirmed via Tc-99m thyroid scintigraphy, demonstrating different patterns of iodine uptake.

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Implications:

  • This case highlights the potential for interferon-alpha therapy to induce multiple, sequential forms of thyroid dysfunction in a single patient.
  • Clinicians should consider monitoring thyroid function closely during and after interferon-alpha treatment, even after initial thyroid abnormalities resolve.
  • The findings suggest a complex interplay between antiviral therapy and the immune system's regulation of thyroid function.