Int J Thyroidol.  2015 Nov;8(2):230-234. 10.11106/ijt.2015.8.2.230.

Interferon-Alpha Induced Severe Hypothyroidism Followed by Graves' Disease in a Patient Infected with Hepatitis C Virus

• Kim KJ
• Lee KW
• Choi JH
• An JH

• KMID: 2171241
• DOI: http://doi.org/10.11106/ijt.2015.8.2.230

Abstract

Interferon-alpha (IFN-alpha) is an important therapeutic agent for hepatitis C virus (HCV) infection, but has various side effects including thyroiditis. We report a case of interferon-induced non-autoimmune hypothyroidism followed by autoimmune-medicated Graves' disease. A 59-year-old woman was diagnosed with chronic active hepatitis C; she had been treated with IFN-alpha and ribavirin for 24 weeks. Before starting the IFN-alpha, her thyroid function was normal and she was negative for autoantibodies. Severe hypothyroidism developed 5 weeks after halting the IFN-alpha, with the Graves' disease phase arising at 32 weeks. For accurate diagnosis and appropriate treatment of thyroid dysfunction during treatment with IFN-alpha, we need to understand and consider rare cases of multiphasic disorder involving both non-autoimmune and autoimmune thyroiditis induced by IFN-alpha.

Keyword

Interferons; Non-autoimmune hypothyroidism; Graves' disease

MeSH Terms

Autoantibodies
Diagnosis
Female
Graves Disease*
Hepacivirus*
Hepatitis C*
Hepatitis*
Hepatitis, Chronic
Humans
Hypothyroidism*
Interferon-alpha*
Interferons
Middle Aged
Ribavirin
Thyroid Gland
Thyroiditis
Thyroiditis, Autoimmune
Autoantibodies
Interferon-alpha
Interferons
Ribavirin

Figure

• 

  Fig. 1. Tc-99m scintigraphy in the thyrotoxic period. (A) After taking levothyroxine for hypothyroidism for 7 weeks. (B) Eight weeks after disconti-nuing levothyroxine with con-firmed TSH receptor antibody positivity.

• 

  Fig. 2. The clinical course of thyroid function in the HCV- infected patient on IFN-α therapy: the biphasic pattern of thyroid function after initiation of IFN-α therapy.

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