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[Dysthyroidism in patients treated with interferon alpha]
P Chédin1, P Chanson, L Duranteau
1Service de Médecine interne, Hôpital Lariboisière, Paris.
Presse Medicale (Paris, France : 1983)
|November 19, 1994
Summary
Alpha-interferon (alpha-IFN) treatment can lead to autoimmune thyroid disease in approximately 1 in 10 patients, manifesting as hypothyroidism or hyperthyroidism. Close thyroid function monitoring is recommended during alpha-IFN therapy.
Area of Science:
- Immunology
- Endocrinology
- Oncology
Context:
- Alpha-interferon (alpha-IFN) exhibits antiviral properties and modulates immune responses.
- Patients with cancer or chronic viral hepatitis are often treated with alpha-IFN.
- Autoimmune thyroid dysfunction is a potential side effect of alpha-IFN therapy.
Purpose:
- To determine the prevalence, clinical course, and predictive factors of autoimmune dysthyroidism in patients receiving alpha-IFN.
- To analyze the types of thyroid dysfunction induced by alpha-IFN.
- To investigate potential pathogenic mechanisms of alpha-IFN-induced thyroid disease.
Summary:
- A meta-analysis of 8 studies involving 573 patients found that 8.7% (47/542) developed dysthyroidism (hypothyroidism, hyperthyroidism, or biphasic) with a mean onset of 9 months.
- Prevalence of antithyroglobulin and/or antimicrosomal antibodies was 13.7%, with lower prevalence for anti-TSH receptor antibodies.
- Pathogenesis may involve alpha-IFN-induced antithyroid antibodies or altered HLA antigen expression on thyrocytes, potentially leading to autoimmune activation.
Impact:
- Alpha-IFN can induce thyroid dysfunction in about 10% of treated patients, likely through autoimmune mechanisms.
- Antithyroid antibodies have a modest positive predictive value (60%) but a high negative predictive value (93%) for predicting dysthyroidism.
- Regular thyroid function monitoring is crucial for patients undergoing alpha-IFN treatment to detect and manage potential adverse effects.