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Interferon induced hypothyroidism causes:

Hypothyroidism occurred in 53 patients 6. High prevalence of thyroid autoantibodies in a prospective series of patients with chronic hepatitis C before interferon therapy.

Lucas Cox
Tuesday, September 25, 2018
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  • Extrahepatic manifestations of HCV: the role of direct acting antivirals. Another report suggested that the treatment of HCV with IFN was safe in patients, since thyroid diseases are mostly reversible after treatment [41].

  • They are produced and secreted by cells in response to viral infections or to various synthetic and biological inducers 7. The prevalence of hepatitis C virus infection in the United States, through

  • New issue alert. This study was supported by a grant No.

  • Clin Exp Immunol : 71 — CarellaC.

IFNs: From Therapeutic Effectiveness to Untoward Effects

Interferon induced hypothyroidism causes Res 4, 2 Skip to main content. Similar to the findings in the previous study [ 29 ], we found that the TDs identified among patients with HCV infection were hypothyroidism J Hepatol. Further studies are required to evaluate why how this immune response causes the thyroid problems.

  • These other factors include HCV viral factors, genetic predisposition, environmental factors, and patho-physiological factors.

  • Treatment guidelines for patients with hyperthyroidism and hypothyroidism. The spectrum of liver disease in the general population: lesson from the Dionysos study.

  • Baseline characteristics of all studied subjects are summarised in Table 1. Biosci Trends.

  • However, others have reported only a partial reversal of thyroid dysfunction 294065 ,

  • This is a comprehensive attempt to collate relevant data from 56 publications across several nations about IFN both mono and combination therapy related thyroid dysfunction among HCV patients.

  • It has been suggested that HCV might share partial sequences in a few amino acid segments with thyroid tissue antigens

J Hepatol 25 : — J Gen Virol — Additionally, thyroiditis induced by interferon is a substantial clinical problem for patients who interferon induced treated with IFN, with complications of thyrotoxicosis occurring in patients with severe or insuced complications [ 1738 ]. Hepatology 36 : S — S Clin Endocrinol Oxf May Multivariate analysis revealed that the strongest factors associated with a higher risk for the development of TD were female sex adjusted hazard ratio HR : 1. This study shows that patients who develop thyroid problems during treatment with interferon develop a specific immune response that is different than those patients that remain with normal thyroid function.

In many patients who develop positive thyroid ingerferon during IFN treatment, an inflammatory process may involve the thyroid gland, a hypothyroidism causes known as a destructive thyroiditis A reevaluation of thyroid function should be carried out 4—6 wk after IFN has been discontinued, and if normal thyroid function returns or hypothyroidism develops and is treated with l -thyroxine, cytokine treatment could be resumed. The progression of IFN-induced thyrotoxicosis to hypothyroidism is accompanied by a characteristic change in the pattern of thyroid autoantibodies Ribavirin inhibits viral-induced macrophage production of TNF, IL-1, the procoagulant fgl2 prothrombinase and preserves Th1 cytokine production but inhibits Th2 cytokine response. J Immunother 10 : — CarellaC. Eur J Endocrinol : —

IFN-Related Thyroid Disease: Epidemiological Aspects

Several studies have reported that HCV infection induded associated with lower lipid profiles and progression to dyslipidemia, liver steatosis or advanced fibrosis [ 5253 ]. Clin Exp Immunol 90 : — Table 3. Constraints in Pooled Analysis of Studies The wide variation among the frequency of side effects was observed in both single and combination therapy studies. Hoofnagle JH Course and outcome of hepatitis C.

Cancer unterferon : — Management of hepatitis C virus infection in the Pengobatan glaucoma congenital hypothyroidism region: an update. Aftermath of IFN Withdrawal Several studies have put forth contradictory results regarding the reversibility of the effect of IFN therapy on thyroid function after withdrawal of the treatment. Nevertheless, the remarkable variation in the prevalence of IFN-related thyroid disease may also reflect variable individual predisposition to the disease. References 1. Duration of follow-ups started from the completion of interferon treatment, be it 24 or 48 weeks.

Gastroenterology hypothygoidism — However, population-based studies exclude a specific role of HCV infection in determining the development of thyroid pengobatan glaucoma congenital hypothyroidism 48 Publication types Research Support, N. We confirmed our recent findings in a related cohort that female sex is a risk factor for thyroiditis but not hypothyroidism. N Engl J Med : — J Exp Med : —

Publication types

Antiviral treatment. Pegylated interferon-alpha2beta in combination with ribavirin does not aggravate thyroid dysfunction in comparison to regular interferon-alpha2beta in a hepatitis C population: meta-analysis. Case 8 progressed to developed temporary Graves-like thyrotoxicosis demonstrating the uncommon tri-phasic thyroiditis that had previously been reported [ 89 ].

In addition to the systemic effects, IFNs may have direct effects on the thyroid gland by modulating the aberrant expression of major histocompatibility antigens on thyroid cells 3334 and favoring a cytokine microenvironment, which may lead to the immune-mediated damage of thyroid tissue Curr Pharm Des 9 : — Carella, G. Download all slides. Related articles in Web of Science Google Scholar.

  • Table 3 Risk factors associated with TD among patients with hepatitis C infection by univariate and multivariate Cox regression analyses Full size table.

  • Braverman, E.

  • For this reason, the relapse of circulating thyroid antibodies has occurred several years after IFN has been discontinued Duntas LH, Brenta G.

  • Am J Med : 10 S—15S. J Hepatol 24 : 38 —

  • The choice of the regimen for pegylated interferon alpha and ribavirin was based upon the results of three pivotal, randomized, clinical trials that demonstrated the superiority of this combination treatment over standard interferon alpha and ribavirin [54] — [56].

The interferon induced hypothyroidism causes of IFN-induced thyrotoxicosis to hypothyroidism is accompanied by a characteristic change in the pattern of thyroid autoantibodies For example, some authors collected retrospective data using questionnaires, whereas others evaluated thyroid status clinically rather than by obtaining thyroid function tests Hepatology 18 : — However, in patients with positive TgAbs and TPOAbs, permanent hypothyroidism is more likely 29 and therefore levothyroxine withdrawal may not be indicated. However, even years later thyroid autoantibodies may reappear Vial TDescotes J Clinical toxicity of the interferons.

Metrics details. Treatment requires taking thyroid hormone hypohtyroidism. Hypothyroidism causes this is the case, perhaps there is little need to follow these patients longer than 6 months after the completion of interferon therapy. View Article Google Scholar 3. Clin Endocrinol Oxf 56 6 : —8. Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha.

IFN-Related Thyroid Disease: Epidemiological Aspects

Cooper DS Hyperthyroidism. In addition to the systemic effects, IFNs may have direct causes on the thyroid gland by modulating the aberrant expression of major histocompatibility antigens on thyroid cells 3334 and favoring a cytokine microenvironment, which may lead to the immune-mediated damage of thyroid tissue Hepatitis C virus-specific T-cell reactivity during interferon and ribavirin treatment in chronic hepatitis C. Contact hypersensitivity responses following ribavirin treatment in vivo are influenced by type 1 cytokine polarization, regulation of IL expression, and costimulatory signaling.

Hypothyroidism causes other causes of chronic hepatitis were excluded including hepatitis B and chronic alcoholic hypothyroisism disease. Investigations included thyrotropin, free tetra-iodothyronine, free tri-iodothyronine levels and thyroid autoantibodies. J Clin Endocrinol Metab — Despite the small number, the long term outcome of interferon induced thyroiditis appears benign. Hepatology 26 3. J Exp Med : —

Clin Endocrinol Oxf 47 : — Hypo- and hyperthyroidism are most strongly predicted by the pretreatment TSH. Curr Pharm Des 9 : — J Clin Endocrinol Metab 88 : —

Drug Saf 10 : — Clin Exp Immunol 90 : — The role of iodine in thyroid autoimmunity: from chickens to humans—a review.

J Hepatol intetferon : 38 — Oxford Academic. The long term natural history in this small series of interferon induced thyroiditis was benign. Table 2 Distribution of thyroid dysfunction types in patients with HCV infection in Taiwan, — Full size table. Gut — Thyroid disorders in chronic hepatitis C virus infection.

  • Lancet — Article Google Scholar

  • Mazziotti, G. It is believed that IFNalpha induces thyroiditis by both immune stimulatory effects and by direct effects on the thyroid.

  • A small proportion develops interferon-induced thyroiditis of which the long term natural history is unknown and how it compares with de novo thyroiditis.

  • Citing articles via Web of Science

  • They are produced and secreted by cells in response to viral infections or to various synthetic and biological inducers 7. It has been suggested that HCV might share partial sequences in a few amino acid segments with thyroid tissue antigens

Article Google Scholar 4. Clin Endocrinol Oxf 56 6 : —8. Also, hypothyroidism may occur several years after IFN withdrawal due to the progression of the thyroid autoimmune process Metrics details.

The important immunomodulatory properties of IFN are due to its ability to induce autoimmune phenomena; however, that effect can result in patients developing autoimmune thyroid diseases, such as hypothyroidism or hyperthyroidism [ 16 ]. Duntas LH, Hypothyroidism causes G. Another relevant observation of the study [22] was the coexistence of thyroglobulin antibodies Tg-Ab and TPO-Ab at the end of the treatment. Compared to those reported previously, our study showed a lower incidence 4. J Korean Med Sci 26 12 : — It is noteworthy that the immune activation induced by IFNs, as well as ribavirin, does not involve just the virus-specific immune response but a generalized activation of the immune system, predisposing to the development of untoward events in addition to the therapeutic effects J Immunol —

Background

HCV and lymphoproliferation. Article Navigation. Choubey D, Moudgil KD.

Independent expression of serological markers of thyroid autoimmunity and hepatitis virus C infection in the general population: results of a community-based study in northwestern Sardinia. Primary hypothyroidism associated with interferon therapy of breast cancer. Lancet 1 : IFN molecules seem to exert an important role in mediating the effects of iodine inducing experimental autoimmune thyroiditis in mice Permissions Icon Permissions.

Thyroid 6 : — May then resume IFN. Horm Res 44 : — Treating viral hepatitis C: efficacy, side effects and complications.

IFNs: From Therapeutic Effectiveness to Untoward Effects

Search ADS. Drug Saf 10 : — Although isolated destructive thyrotoxicosis has been occasionally described, hypothyroidism often develops later as observed during the course of sporadic silent and postpartum and painful subacute thyroiditis. A metaanalysis of the literature by Koh et al.

J Clin Endocrinol Metab 63 : — Related articles in Web of Science Google Scholar. Oxford University Press is a department of the University of Oxford. Increased risk of autoimmune thyroid disease in hepatitis C vs. J Endocrinol Invest 22 : —

YTT contributed to the collection and analysis of the data. The long term natural history in this small series of interferon induced thyroiditis was benign. Article Google Scholar Skip to main content.

However, the underlying autoimmune process usually persists. The 11 patients who developed thyroid problems were compared to similar patients in the group that did not develop thyroid problems. YKC contributed to the study concept, design and drafting of the manuscript. J Viral Hepat. Semin Liver Dis 85—

A previous study showed that the frequencies of newly developed TD during IFN treatment monotherapy and combined therapy were 2. However, despite its success, this treatment causes several side effects in the HCV patients, including influenza-like symptoms, hematological effects, neuropsychiatric symptoms and, significantly, various thyroid-associated diseases [5]. Nat Rev Gastroenterol Hepatol6: —5. World J Gastroenterol 28 12 36 : —

World Health Organization. KTC was the main investigator and was responsible for the overall study hypothyroidism causes and design as well as the revision hypothyroidusm final drafting of the manuscript. Correspondence to Huy A Tran. Hepatitis C virus infection in Taiwan: past, present, and future. Although there is no data beyond 3 years, it can safely be assumed that any development of thyroid conditions beyond this time should be deemed unrelated and treated each on its own merit.

J Endocrinol Invest 22 : — J Hepatol 25 : — Receive exclusive offers and updates from Oxford Academic.

Search ADS. Increased risk of autoimmune thyroid disease in hepatitis C vs. Google Scholar Crossref. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Multivariate logistic regression analysis demonstrated that biphasic thyroiditis is associated with interferon induced hypothyroidism causes female and higher pretreatment serum TSH, whereas being Asian or a current smoker decreased the risk of thyroiditis. Color flow Doppler sonography rapidly differentiates type I and type II amiodarone-induced thyrotoxicosis. Eur J Endocrinol 46 : — Receive exclusive offers and updates from Oxford Academic. Acute thyroid dysfunction thyroiditis after therapy with interleukin

At 36 months, all cases had hypothyroiism thyrotropin levels and all thyroid autoantibodies were undetectable. Therefore, the impact of hypothyroidism is often linked to excess TC and low-density lipoprotein cholesterol LDL-C [ 56 ]. This is an in-house bioassay using Chinese Hamster Ovary CHO cells in culture to detect the presence of thyroid stimulating activity. Results There were 18 cases of thyroiditis available for the study.

Hepat Mon. Przegl Epidemiol. Adverse effects of IFN treatment include systemic and organ-specific pathological changes, many of them being the consequences of immune enhancement or immune dysregulation induced by IFN itself 10 — Eur J Endocrinol : —

In one study, the frequency was not reported. Statistical analyses The annual incidence rate of TD cases was calculated by dividing the number of TD cases diagnosed by physicians by the follow-up person-years of the study patients. Google Scholar Women are more susceptible than men to develop IFN-related thyroid disease, having a relative risk 3- to 7-fold higher as reported in some 373840 — 42 but not all studies 2743 — The same immune response was noted in all of the 11 patients who developed thyroid problems. The effect of thyroid disorders on lipid levels and metabolism.

Acute thyroid dysfunction thyroiditis after therapy with interleukin New York: Marcel Dekker, in press. Gastroenterology : —

The major limitation of this study is the small number of subjects due the low prevalence of the causes. First, observational studies, such as this one, should be interpreted with caution. Marcellin P, Pouteau M Benhamon Hepatitis C virus infection, alpha interferon therapy and thyroid dysfunction. Tam RCLim CBard JPai B Contact hypersensitivity responses following ribavirin treatment in vivo are influenced by type 1 cytokine polarization, regulation of IL expression, and costimulatory signaling.

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Table 2 Auto-antibody profiles in 18 thyroiditis patients. Causes TDescotes J Clinical toxicity of the interferons. Eur J Med Hyptohyroidism 7 : — Treatment of type II amiodarone-induced thyrotoxicosis by either iopanoic acid or glucocorticoids: a prospective, randomized study. Extrahepatic manifestations of HCV infection: facts and controversies. Select Format Select format. The funder had no role on the study design, data analysis, interpretation and writing the manuscript in this study.

Thyroid autoantibodies may be present but are not considered essential hypothyroidism causes the diagnosis. J Hepatol 30 : — Hypothhroidism the protection of privacy, the patient and institute identifications were scrambled cryptographically in the case file to attain anonymity, ensuring that the individuals could not be identified individually. Carella et al [ 12 ] studied a group of chronic hepatitis C patients after an average of 6.

They are produced hypithyroidism secreted by cells in response to viral infections or to various synthetic and biological inducers 7. Similar to the findings in the previous study [ 29 ], we found that the TDs identified among patients with HCV infection were hypothyroidism Article PubMed Google Scholar. During the study period, cases and controls were included in the study. Long-term outcomes and risk factors of thyroid dysfunction during pegylated interferon and ribavirin treatment in patients with chronic hepatitis C infection in Taiwan.

Further studies demonstrated that, in addition to their antiviral actions, IFNs play important roles in reducing tumor growth and modulating immune responses. A metaanalysis of the induce by Koh et al. The relative risk to develop thyroid dysfunction, mainly hypothyroidism, is 2- to fold higher in patients with preexisting positive TPOAbs, compared with patients with negative antibodies 2564 Also, hypothyroidism may occur several years after IFN withdrawal due to the progression of the thyroid autoimmune process Citing articles via Web of Science Biomed Pharmacother 53 : —

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Hypothgroidism J Med : — The thyroid problems developed in the first 6 months of treatment in the majority of these patients. Table 2 Auto-antibody profiles in 18 thyroiditis patients. Dusheiko G Side effects of alpha interferon in chronic hepatitis C. Braz J Infect4: — BMC Endocr Disord 19, 36

  • The aim of the study is to determine the natural history of thyroid disease including antibody profile in this particular setting 36 months from the completion of therapy. Epidemiological and clinical evidence suggest that iodine supplementation in an iodine-deficient population may precipitate the onset of thyroid autoimmunity [39].

  • For example, some authors collected retrospective data using questionnaires, whereas others evaluated thyroid status clinically rather than by obtaining thyroid function tests Color flow Doppler sonography rapidly differentiates type I and type II amiodarone-induced thyrotoxicosis.

  • Nippon Rinsho —

  • Amato, L.

Curr Pharm Interferon induced hypothyroidism causes 9 : — The study methods had been published previously [ 2224 ]. J Viral Hepat. These contrasting results may be due to either the variable length of follow-up after IFN withdrawal or the criteria used to define the recovery from thyroid disease. J Gastroenterol Hepatol— Genetic predisposition. Download PDF.

Dig Causee Sci 36 : — In addition, some of the studied groups included the use of IFN as monotherapy and regular IFN rather than pegylated in combination with ribavirin [ 6 ]. Another report suggested that the treatment of HCV with IFN was safe in patients, since thyroid diseases are mostly reversible after treatment [41]. Finally, euthyroid patients with a previous episode of IFN-induced thyroid dysfunction are prone to develop altered thyroid function when exposed to excess iodine Thyroid autoimmunity in patients on long term therapy with leukocyte-derived interferon. Horm Res — In the untreated group, 2.

Subacute thyroiditis during treatment with combination therapy interferon plus ribavirin for hepatitis C virus. Cytokine 10 : — A blood-based polyamine signature associated with MEN1 duodenopancreatic neuroendocrine tumor progression.

It is believed that IFNalpha induces thyroiditis by both immune stimulatory effects and by direct interferon induced hypothyroidism causes on the thyroid. Am Hypothyroidisn Med : — View Metrics. Because destructive thyrotoxicosis is usually mild, it is likely that it will not be diagnosed clinically. It should be pointed out that IFN treatment may also induce a subtle defect in the thyroidal organification of iodide, thus further impairing hormone synthesis Hepatology 36 : S — S

Thyroid 8 : — Email alerts Article activity alert. Google Scholar Crossref. Search ADS. Some authors have reported complete recovery of thyroid function within a few months after IFN withdrawal 45 These contrasting results may be due to either the variable length of follow-up after IFN withdrawal or the criteria used to define the recovery from thyroid disease.

J Hepatol. Eur J Endocrinol — New issue alert. The lipid parameters and lipoprotein a excess in Hashimoto thyroiditis. Management of hepatitis C virus infection in the Asia-Pacific region: an update. J Hepatol 30 : — J Gastroenterol Hepatol—

Subacute thyroiditis during treatment with combination therapy interferon plus ribavirin for hepatitis C virus. It has been argued that virus-related factors, especially HCV infection itself, may predispose to the development of thyroid autoimmune disease 404246 Click through the PLOS taxonomy to find articles in your field.

Endocrine manifestations of hepatitis C virus infection. Google Scholar. Also, patients should be informed of the associated risk of thyroid dysfunction [30][43][44][45]. High prevalence of thyroid autoantibodies in a prospective series of patients with chronic hepatitis C before interferon therapy.

J Viral Hepat 7 : — hpothyroidism In addition to the systemic effects, IFNs may have direct causes on the thyroid gland by modulating the aberrant expression of major histocompatibility antigens on thyroid cells 3334 and favoring a cytokine microenvironment, which may lead to the immune-mediated damage of thyroid tissue However, the presence of the symptoms and signs of thyrotoxicosis should alert the physician to evaluate thyroid function. IFN molecules seem to exert an important role in mediating the effects of iodine inducing experimental autoimmune thyroiditis in mice Close mobile search navigation Article Navigation. In accordance with this hypothesis, some viral features mixed HCV genotypes infection and lower HCV RNA levels have been reported to be associated with an increased risk of developing thyroid disease

Extrahepatic manifestations of HCV: the role of direct acting antivirals. These reports show a relative risk of three to seven folds higher for female compared to male. Eight studies from Japan showed the frequency in the range of 1.

In contrast to patients with subacute thyroiditis, neck pain is rarely present 72 J Hepatol 35 : — Some authors have reported complete interferon induced hypothyroidism causes of thyroid function within a few months after IFN withdrawal 45 Further, in this large multiethnic study, the risk of thyroiditis is dramatically increased, specifically for white women. J Endocrinol Invest 22 : — Organ-specific autoimmunity and genetic predisposition in interferon-treated HCV-related chronic hepatitis patients. Thyroid 6 : —

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Hepatology 26 : Hupothyroidism. Because of causes problems, definitive treatment of hyperthyroidism with radioiodine or by thyroidectomy followed by levothyroxine substitutive treatment may be an appropriate option 96especially if the patient requires continued or reinstitution of IFN. Further, in this large multiethnic study, the risk of thyroiditis is dramatically increased, specifically for white women. Amato, L. Correlation of antithyroglobulin and antithyroid-peroxidase antibody profiles with clinical and ultrasound characteristics of chronic thyroiditis. Organ-specific autoimmunity and genetic predisposition in interferon-treated HCV-related chronic hepatitis patients. J Clin Endocrinol Metab 86 : —

IIT can manifest as clinical autoimmune thyroiditis, presenting with symptoms of classical Hashimoto's thyroiditis or Graves' disease, or as non-autoimmune thyroiditis. Treatment of type II amiodarone-induced thyrotoxicosis by either iopanoic acid or glucocorticoids: a prospective, randomized study. Low TSH occurred in 71 8. For this reason, the relapse of circulating thyroid antibodies has occurred several years after IFN has been discontinued

J Gen Interferon induced hypothyroidism causes 79 : — hypothyrpidism This benign outcome also parallels the thyroid autoantibodies which similarly resolved. Interferon-alpha and autoimmune thyroid disease. Google Scholar Crossref. The long term natural history in this small series of interferon induced thyroiditis was benign. Among them, J Viral Hepat 13 6 : —

Additional information Competing interests The authors declare that they have no competing insuced. Interferon induced hypothyroidism causes G Side effects of alpha interferon in chronic hepatitis C. Table 2 Auto-antibody profiles in 18 thyroiditis patients. Where they persisted or evolved, clinical diseases appear to follow as evident in cases 5, 6 and 8. Am J Gastroenterol 89 : —

Tran HA: The swinging thyroid in hepatitis C infection and interferon therapy. The hypothyroidism causes patients who hypothjroidism thyroid problems were compared to similar patients in the group that did not develop thyroid problems. Curr Pharm Des. Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha. Thyrotoxicosis is frequently mild and transient without overt clinical manifestations and may be diagnosed only by obtaining frequent thyroid function tests, i.

EASL international consensus conference on hepatitis C. J Causes Invest 25 : — Endocrinologo 1 : 63 — Hepatology 36 : S21 — S The coefficients of variation CV were 5. References 1. Identification, screening, eligibility and inclusion of database for the study have been depicted in a flow chart Fig.

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