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Treatment of interferon induced hypothyroidism and weight – INTERFERON ALPHA TREATMENT AND THYROID DYSFUNCTION

Autoimmunity and thyroid function in patients with chronic active hepatitis treated with recombinant interferon alpha-2a.

Matthew Cox
Monday, October 19, 2020
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  • Jason T. Mean and standard deviation of age, S.

  • Thyroid and Weight FAQs.

  • A Prospective Cohort Study.

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Mechanisms of action and clinical applications. However, population-based studies exclude a specific role of HCV infection in determining the development of thyroid disease 48 Both her endocrinopathy and the pituitary hyperplasia resolved with discontinuation of the interferon treatment and with institution of thyroid replacement therapy.

J Endocrinol Invest 20 : 24 — Cancer 92 : — Adherence to therapeutic regimen, younger age, female sex, viral genotype 3, and lower body weight are factors associated with better treatment response of the patients. Genetic predisposition.

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Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. T3 levels; reference range being 1. Hashimoto encephalopathy with pegylated interferon alfa-2b and ribavirin. J Hepatol 25 : — Copyright notice.

Effects fo interferon-alpha IFN-alpha administration on leucocytes in healthy humans. Indeed, it has been demonstrated that the Th1-like immune response is an important factor for the development and maintenance of organ-specific autoimmune diseases [43,44]. Clin Exp Med 3 4 : — The aims of this study were to determine the incidence and long-term outcome of thyroid dysfunction in HCV-infected men receiving interferon and ribavirin combination therapy.

Other causes are iodine deficiency, surgery and neck radiation. Interruption of IFN therapy may not always be required except in patients with severe symptoms. Ribavirin polarizes human T cell responses treatment of interferon induced hypothyroidism and weight a type 1 cytokine profile. 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 — Oxford University Press is a department of the University of Oxford. Publication types Research Support, N.

Hepatitis Research and Treatment

Contact hypersensitivity responses following ribavirin treatment in vivo are influenced by type 1 cytokine polarization, regulation of IL expression, and costimulatory signaling. Select Format Select format. View Metrics. The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck.

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  • Ultrasound evaluation of the thyroid gland, especially if performed with the auxiliary application of a quantitative computerized analysis 7475shows a diffuse hypoechogenicity accompanied sometimes by reduced vascularity color flow Doppler as observed in other types of destructive thyroiditis

  • The presence of HCV particle within the thyroid cells may additionally contribute further damage to the thyroid gland View at: Google Scholar M.

Thyroid autoimmunity in patients on long term therapy with leukocyte-derived interferon. Clin Infect Dis. Clinicians should routinely examine for signs of thyroid dysfunction such as tachycardia or bradycardia, heat or cold intolerance, and unexpected weight change. Am J Gastroenterol 89 : — Oxford Academic. Cytolytic T-cell cytotoxicity is mediated through perforin and Fas lytic pathways. Villanueva RB, Brau N.

Clin Dev Immunol. J Hepatol 30 : hypothytoidism Linkage analysis of candidate genes in autoimmune thyroid disease: 2. Boulestin A. In this review, we will review the epidemiology and clinical manifestations of IIT as well as the mechanisms causing IIT, focusing on the role of hepatitis C virus. This is a predictive factor for the presence of thyroid dysfunction, even if subclinical, many years after IFN withdrawal. For this reason, the relapse of circulating thyroid antibodies has occurred several years after IFN has been discontinued

  • Clin Endocrinol Oxf 50 : — Address for correspondence: Dr.

  • Abstract Objective: To present the first reported case of interferon-induced hypothyroidism with radiographic confirmation of secondary pituitary hyperplasia.

  • The interferons. Clinical Endocrinology 56 —

  • Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha. Females and Asians are at higher risk, and hypothyroidism is more common than hyperthyroidism [ 10 — 19 ].

  • The clinical and physiological spectrum of interferon-alpha induced thyroiditis: Toward a new classification. Table 1 reports the frequency of newly developed thyroid antibodies and thyroid dysfunctions in HCV patients from 31 previous studies, with single and 25 studies pertaining to combination IFN therapy Table 2.

  • A randomized, double-blind trial comparing pegylated interferon alfa-2b to interferon alfa-2b as initial treatment for chronic hepatitis C.

Accepted 19 Jul Another relevant observation of the study [22] was the coexistence of thyroglobulin antibodies Tg-Ab and TPO-Ab at the end of the treatment. Taken together, this preliminary evidence supports a genetic role in the etiology of IIT. Arch Intern Med ; Though a number of studies have been carried out about the varying manifestation of thyroid disease and its pathogenesis, association of thyroid disease with severity of disease or response to treatment are reported with varying results. View at: Google Scholar Y.

Advanced Search. Thyroid dysfunction is a known complication of interferon treatment in patients with hepatitis C virus HCV infection. Publication types Case Reports. Citing articles via Web of Science Non-autoimmune thyroiditis can manifest as destructive thyroiditis, with early thyrotoxicosis and later hypothyroidism, or as non-autoimmune hypothyroidism. The thyroid gland is a butterfly-shaped endocrine gland that is…. Skip Nav Destination Article Navigation.

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If a high BMR is induced by the administration of drugs, such as amphetamines, animals often have a negative energy balance which leads to weight loss. Massive weight gain is rarely associated with hypothyroidism. A genetic predisposition to thyroid autoimmune disease is probably necessary for the development of thyroid disease in patients treated with IFN 27 —

The presence of auto-antibodies should not be regarded as a contraindication for IFN therapy. Clin Fo Oxf 59 : — Further studies demonstrated that, in addition to their antiviral actions, IFNs play important roles in reducing tumor growth and modulating immune responses. The duration of destructive thyrotoxicosis is variable, ranging from a few weeks to a few months. However, BMRs are not the whole story relating weight and thyroid. Permissions Icon Permissions. Carella, G.

Increased risk of autoimmune thyroid disease in hepatitis C vs. What is the thyroid gland? Clin Endocrinol Oxf 59 : — In treatment of interferon induced hypothyroidism and weight, screening for hypothyroidism should be performed in patients receiving interferon. It is seen more frequently in patients on IFN-alpha with chronic HCV infection than in chronic hepatitis B infection, suggesting a synergistic role of HCV and IFN-alpha [ 2 ], HCV may result in an induction of IFN in the thyroid gland which activates natural killer cells, leading to proliferation of memory T cells and prevention of apoptosis, thus raising the thyroid auto-antibodies titer. A metaanalysis of the literature by Koh et al.

IFNs: From Therapeutic Effectiveness to Untoward Effects

Download PDF. Morisco, G. J Endocrinol Invest ; Pre-existing thyroid autoimmunity can emerge as an important risk factor for developing thyroid dysfunction during IFN therapy.

Huang, W. Therapeutic regimen-related factors may influence the development of thyroid disease. PEG-drug conjugates exhibit enhanced solubility, reduced antigenicity, reduced sensitivity to proteolysis, and reduced rate of kidney clearance. Interferons, a group of multiple lymphokines. Severe and even life-threatening side effects of IFN reportedly occur in 0. Wong, A. Molecular mechanism of hepatic injury in coinfection with hepatitis C virus and HIV.

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Conjugation of polyethylene glycol PEG to a pharmaceutical protein is weighht method that increases the lifetime blood circulation of drug. These data suggested that HCV envelope proteins themselves could significantly impact the thyroid environment and contribute to thyroid dysfunction. Clin Dev Immunol. J Exp Med : — Long-term outcome of interferoninduced thyroid autoimmunity and prognostic influence of thyroid autoantibody pattern at the end of treatment. Fu, J.

Eur J Endocrinol 46 : — This was confirmed at week 24, and other laboratory values showed low levels of adrenocorticotrophic hormone ACTH. Environ Health Perspect : — Mechanisms of action and clinical applications. Eur J Cancer Clin Oncol 24 : — We also reiterate the value of testing for thyroid dysfunction and anti-thyroid antibodies in patients with HCV infection planned for IFN therapy. Some patients treated with thyroxine before IFN-alpha treatment may require increased doses during therapy and decreased doses after IFN-alpha therapy has been completed.

Non-autoimmune thyroiditis can manifest as treatment of interferon induced hypothyroidism and weight thyroiditis, with early thyrotoxicosis and later hypothyroidism, or as non-autoimmune hypothyroidism. Hepatology 26 : — On investigation, his hematological and biochemical profile were normal. The excessive release of thyroid hormones by the damaged thyroid follicles is responsible for the occurrence of thyrotoxicosis similar to that observed in subacute, postpartum, and sporadic silent thyroiditis 71 — Thyroid 7 : — 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 — Learn More.

Introduction

Yaron Tomer, James J. Diagnosis and management of hypothyroidism. Immunol Today. Longitudinal study of antibodies against thyroid in patients undergoing interferon-alpha therapy for HCV chronic hepatitis.

Based on such studies many people have concluded that changes in thyroid hormone levels, which lead to changes in BMR, should also cause changes in energy balance and similar changes in body weight. 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 In patients treated with IFN, activation of the immune system is important for the development of thyroid disease. Cytokine 10 : — Thyroid 6 : —

Table 1 Biphasic thyroiditis in three cases. Search for hepatitis C virus extrahepatic replication sites in patients with acquired immunodeficiency syndrome: specific detection and weight negative-strand viral RNA in various tissues. Lowin B. However, the presence of the symptoms and signs of thyrotoxicosis should alert the physician to evaluate thyroid function. However, its use is not without side-effects, among which is the emergence of autoimmune diseases favored by the immunomodulating properties of this molecule. Ann Hematol. The occurrence of thyroid dysfunction is the most common autoimmune response to interferon and ribavirin therapy.

IFN-Related Thyroid Disease: Epidemiological Aspects

However, others have reported only od partial reversal of thyroid dysfunction 294065 A T1-weighted magnetic resonance imaging scan demonstrated high intensity of the anterior pituitary gland and enhancement after intravenous administration of gadolinium. Correlation of antithyroglobulin and antithyroid-peroxidase antibody profiles with clinical and ultrasound characteristics of chronic thyroiditis. Mazziotti, G. Subacute thyroiditis during treatment with combination therapy interferon plus ribavirin for hepatitis C virus.

It is important that hepatologists and endocrinologists work together in the care of these patients. Persistent thyroid autoimmunity after subacute thyroiditis. At least 1 og autoantibody was present in all 12 patients, including antithyroglobulin antibodies in 11 and antithyroid peroxidase antibodies in Searching for the autoimmune thyroid disease susceptibility genes: From gene mapping to gene function. Autoimmunity and thyroid function in patients with chronic active hepatitis treated with recombinant interferon alpha-2a.

Our study demonstrates that overt thyroid dysfunction occurs in 6. T3 level were measured by chemiluminescence method. J Intern Med — Deutsch M.

Thyroid and Weight FAQs

Latent autoimmune thyroiditis in untreated patients with HCV chronic hepatitis: a case-control study. However, its use is not without side-effects, among induced hypothyroidism is the emergence of autoimmune diseases favored by the immunomodulating properties of this molecule. Get free access to newly published articles Create a personal account or sign in to: Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.

  • Hepatitis C and human immunodeficiency virus envelope proteins cooperatively induce hepatocytic apoptosis via an innocent bystander mechanism.

  • The stimulation of cytotoxicity is mainly due to an up-regulation of perforin expression in peripheral natural killer and T cells 13very likely sustained by suppression of T helper Th 2 and an increase in Th1 immune response 14 —

  • The diagnosis of IIT is not always simple and straightforward.

  • Thyroid 10 : Thyroid hormone regulates metabolism in both animals and humans.

Treatment of interferon induced hypothyroidism and weight is higher than in those hypothhroidism with IFN alone 6. Biologic responses to IFN-alpha administration in humans. Follow us on: Share Share. Genetic studies to identify the genetic factors contributing to the development of IIT in order to develop prediction algorithms and prevention strategies. This study further suggested that the pegylation of IFN, in combination with RBV, had no aggravating effect on thyroid diseases in the hepatitis C-afflicted population [17]. J Endocrinol Invest 20 : 24 —

References 1. Extrahepatic manifestations associated with hepatitis C virus infection. View Metrics. Acute thyroid dysfunction thyroiditis after therapy with interleukin Clin Endocrinol Oxf —

References

Malcolm Reeves, R. Interferons: mechanisms of action and clinical applications. Immuno Cell Biol 24— Over-expression of class I antigens is associated with activation of cytotoxic T cells, and thus can lead to tissue damage and inflammatory response

  • J Hepatol 25 : — Hoofnagle JH Course and outcome of hepatitis C.

  • Minelli RRoti E Interferone e tireopatie.

  • While intact, infectious hepatitis C virions are responsible for productive infection, viral proteins that are shed for virions or that are part of non-infectious virions may also have important physiological consequences. Treatment of chronic hepatitis C with consensus interferon: a multicenter, randomized, controlled trial.

  • Hyperthyroidism It is autoimmune hyperthyroidism. Bartenschlager R, Lohmann V.

IFN-alpha is totally filtered through the glomeruli and undergoes rapid proteolytic degradation during tubular reabsorption, rendering a negligible reappearance of intact IFN-alpha in the systemic circulation. The RIBA is activated by cellular kinases which change it into the 5' triphosphate nucleotide. Interferon-alpha The IFN are a group of proteins called cytokines produced by white blood cells, fibroblasts, or T cells as part of an immune response to a viral infection or other immune trigger. Antiviral actions of interferons [Review]. Thus, a potential mechanism exist whereby HCV itself infects thyroid cells, or its envelope proteins bind to thyroid cells, triggering cytokine secretion that can activate resident T-cells and, in genetically susceptible individuals, result in thyroid autoimmunity through a bystander mechanism. A prospective multicenter study of patients. Clin Exp Med 3 4 : —

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. We recently tested several candidate genes for association with IIT. Furthermore, host immune selection pressures may drive the outgrowth and selection of viral variants capable of persisting despite the presence of an antiviral response directed against HCV or antiviral treatment. Cacoub P.

IFN-Related Thyroid Disease: Epidemiological Aspects

Such associations have been reported in which presence of thyroid auto-antibodies and thyroid disease are correlated with better and sustained treatment response [ 202225 ]. The 99 Tc scintiscan showed an intense diffuse and homogeneous uptake Fig. Interferons: mechanisms of action and clinical applications. J Endocrinol Invest — These data suggested that HCV envelope proteins themselves could significantly impact the thyroid environment and contribute to thyroid dysfunction.

Hepatitis C virus entry: molecular biology and clinical implications. Ribavirin hypothytoidism human T cell responses toward a type 1 cytokine profile. Tilg H. Create a personal account to register for email alerts with links to free full-text articles. Curr Opin Oncol. These viral variants may display divergent phenotypic properties, such as altered replication capacity or fitness, cell tropism, immunologic escape, and antiviral drug resistance Oppenheim Y.

They are produced and secreted by cells in response to viral infections or to various synthetic ihduced biological inducers 7. This article has been cited by other articles in PMC. The thyroid autoantibody pattern at the end of IFN therapy may be a reliable marker for the subsequent outcome of thyroid function Thyroid hormones have been used as a weight loss tool in the past.

IFNs: From Therapeutic Effectiveness to Untoward Effects

Searching for the autoimmune thyroid disease susceptibility genes: From gene mapping to gene function. Dig Dis Sci — Yypothyroidism Hepatitis Interventional Therapy Group IHITRandomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. The relation between severity of the chronic hepatitis C disease and development of thyroid dysfunction was determined.

  • These cases are often characterized by a transient hyperthyroidism followed by a longer hypothyroid phase, which often becomes permanent [58]. Figure 1.

  • J Hepatol 30 : — As in the treatment with hyperthyroidism, treatment of the abnormal state of hypothyroidism with thyroid hormone results in a return of body weight to what it was before the hypothyroidism developed.

  • Tong M. Because of these effects, IFNs have been widely used in the treatment of neoplastic, viral, and autoimmune diseases.

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Koh L. Development of transient thyroid disease and reaction during treatment of chronic hepatitis C with interferon. Skip Nav Destination Article Navigation. Abstract Objective. View Metrics.

The probable reason for the negative association could be that the immune responses responsible for thyroid disease and those regulating therapeutic response are not the same. Virologic factors related to interferon-alpha-induced thyroid dysfunction in patients with chronic hepatitis Interfron. The characteristic features of thyroid dysfunction in hepatitis C individuals treated with IFN-alpha and RIBA are generally similar to post-partum or Hashimoto's thyroiditis: autoimmune process, presence of anti-TPO antibodies, variable clinical expression, biphasic presentation in some patients, heterogeneous thyroid parenchyma at ultrasound and negative scintigraphy [56]. Follow-up was performed until June 30,and the duration of follow-up was calculated as the time since the completion of HCV therapy until the last time that the patient was seen in the outpatient clinic. Thyroid abnormalities in chronic viral hepatitis and their relationship to interferon alfa therapy. References 1. Advanced Search Help.

Thyroid 12 : — Therapy for hyperthyroidism was continued for 4 weeks after HCV therapy was completed and then tapered during the next 8 weeks. Matsuda J.

Akeno N, Tomer Y. Importantly, a recent study has demonstrated that hepatic binding of interffron glycoproteins — without productive HCV infection — results in a cascade of intracellular signals that modulate cellular gene expression, in particular genes critical to innate immune responses and lipid metabolism Over-expression of class I antigens is associated with activation of cytotoxic T cells, and thus can lead to tissue damage and inflammatory response Is the IFN-alpha-related thyroid autoimmunity an immunologically heterogeneous disease?

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Thomas, J. BMC Endocr Disord Every year there are estimates of 3 to 4 million new cases of infection due to transfusion contamination, contaminated injection needles, and parenteral exposure [1]. New insights into the mechanisms of interferon alpha: an immunoregulatory and anti-inflammatory cytokine. Ferrari, P. Virologic factors related to interferon-alpha—induced thyroid dysfunction in patients with chronic hepatitis C.

At week 20 of treatment, her routine laboratory control showed low induded of thyroid-stimulating hormone TSH and free serum thyroxine. Hepatology 36 : S — S Treatment of type II amiodarone-induced thyrotoxicosis by either iopanoic acid or glucocorticoids: a prospective, randomized study. Furthermore, IFN has direct inhibitory effects on thyroid hormone synthesis, release, and metabolism 24 —

INTRODUCTION

New York: Academic Press, The addition of ribavirin to interferon-alpha therapy in patients with hepatitis C virus-related chronic hepatitis does not modify the thyroid autoantibody pattern but increases the risk of developing hypothyroidism. Journal of Clinical Endocrinology and Metabolism 79 — Autoimmune thyroiditis may not be reversible after IFN therapy [13]but a complete recovery of thyroid function within a few months of IFN withdrawal was also reported in earlier studies [34][41]. Binding of the hepatitis C virus envelope protein E2 to CD81 provides a co-stimulatory signal for human T cells.

The heart sounds were feeble. We do not have sufficient literature and personal experience to suggest the timing for testing thyroid function to identify all patients developing and weight. Based on such studies many people have concluded that changes in thyroid hormone levels, which lead to changes in BMR, should also cause changes in energy balance and similar changes in body weight. Because all of these substances interact with the parts of the brain and body that control energy expenditure and energy intake, we cannot predict the effect of altering only one of these factors such as thyroid hormone on body weight as a whole.

Autoimmunity 13 : 61 — Lack of evidence for the Th2 predominance in patients with chronic hepatitis C. Since the BMR in the patient with treatment of interferon induced hypothyroidism and weight see Hypothyroidism brochure is decreased, an underactive thyroid is generally associated with some weight gain. Further studies demonstrated that, in addition to their antiviral actions, IFNs play important roles in reducing tumor growth and modulating immune responses. It is seen more frequently in patients on IFN-alpha with chronic HCV infection than in chronic hepatitis B infection, suggesting a synergistic role of HCV and IFN-alpha [ 2 ], HCV may result in an induction of IFN in the thyroid gland which activates natural killer cells, leading to proliferation of memory T cells and prevention of apoptosis, thus raising the thyroid auto-antibodies titer.

  • For instance, Laskus et al. Clinical Immunology and Immunopathology.

  • Permissions Icon Permissions. The low rates are likely an underestimation of the true prevalence because in some studies a careful evaluation of thyroid status was not carried out

  • Amato, L. Specifically, the presence of TPO-Ab before treatment was a statistically significant risk factor for developing thyroid disease in patients treated with interferon 12 ;

  • J Steroid Biochem Mol Biol.

Parmar S, Platanias LC. Chuang, C. The duration of destructive thyrotoxicosis is variable, ranging from a few weeks to a few months. Hypothyroididm risk of autoimmune thyroid disease in hepatitis C vs hepatitis B before, during, and after discontinuing interferon therapy. In contrast, none of these individuals had thyromegaly, thyroid nodules, bradycardia, cold intolerance, or edema. Subacute thyroiditis during treatment with combination therapy interferon plus ribavirin for hepatitis C virus.

Mechanisms of action and clinical applications. The patient made gradual recovery and is presently asymptomatic. Hypothyroidism is a common endocrine disorder. He spoke slowly with a heavy voice.

J Med Virol. Ann Pharmacother. Perhaps the true prevalence of this disorder is interferob higher than that reported in the literature because it is often transient and has mild clinical manifestations and, therefore, can be easily missed 55 Prevalence and significance of thyroid autoantibodies in patients with chronic hepatitis C virus infection: a prospective controlled study. There are three types of IFN: alpha, beta, and gamma.

In many patients who develop positive thyroid antibodies during IFN treatment, an inflammatory process may involve the thyroid gland, a process known as a destructive thyroiditis Massive weight gain is rarely associated with hypothyroidism. Magrassi and A. Based on such studies many people have concluded that changes in thyroid hormone levels, which lead to changes in BMR, should also cause changes in energy balance and similar changes in body weight. Epidemiological and clinical evidence suggests that iodine supplementation in an iodine-deficient population may precipitate the onset of thyroid autoimmunity 50 Bim EJ, Mehandru S. Eur J Endocrinol 46 : —

The incidence of interferon-induced thyroid autoimmunity has been reported to range from 2. In addition, 9 patients 4. Eur J Endocrinol — Specifically, the presence of TPO-Ab before treatment was a statistically significant risk factor for developing thyroid disease in patients treated with interferon 12 ; Studies from other countries with 1—3 studies also demonstrated similar wide variations in the frequency of newly developed thyroid antibody and thyroid dysfunctions Table 2. Signal transducer and activator of transcription Stat dependent, but not Stat4-dependent, immunity is required for the development of autoimmunity in Graves' hyperthyroidism. Evolution of thyroid autoimmunity during iodine prophylaxis—the Sri Lankan experience.

Hoofnagle JH Course and outcome of hepatitis C. Lancet 1 : Abstract Objective: To present the first reported case of interferon-induced hypothyroidism with radiographic confirmation of secondary pituitary hyperplasia.

Akeno N, Tomer Y. Villanueva RB, Brau N. Mechanisms of action and clinical applications. Lauer G.

  • Ferri, and P. Doi, S.

  • Other causes are iodine deficiency, surgery and neck radiation. It has been appreciated for a very long time that there is a complex relationship between thyroid disease, body weight and metabolism.

  • Incidence of dysthyroidism during interferon therapy in chronic hepatitis C. Takagi et al.

  • Thyroid abnormalities in chronic viral hepatitis and their relationship to interferon alpha therapy.

  • Ultrasound evaluation of the thyroid gland, especially if performed with the auxiliary application of a quantitative computerized analysis 7475shows a diffuse hypoechogenicity accompanied sometimes by reduced vascularity color flow Doppler as observed in other types of destructive thyroiditis

Because hyperthyroidism is an abnormal state, we can predict that any weight loss caused by the abnormal state would go away when the abnormal state is reversed. J Intern Med : — Patients treated with both drug do not have an increased risk of developing thyroid autoimmunity but do have a 4. Increased risk of autoimmune thyroid disease in hepatitis C vs. Methods: We describe the case of a woman with recurrent malignant melanoma, outline the details of her endocrine work-up, and illustrate the serial findings on magnetic resonance imaging of the head.

Hepatitis C virus-specific T-cell reactivity during interferon and ribavirin treatment in chronic hepatitis C. Eur J Endocrinol. If antibodies are negative I uptake and scan may be performed. Subclinical hypothyroidism resolved spontaneously in all 6 patients after completion of HCV therapy. Gender and ethnicity.

Treatment guidelines for patients with hyperthyroidism and hypothyroidism. Starting or increasing thyroid hormone to cause thyroid hormone levels to be elevated is unlikely to dramatically change weight. Braverman, M.

Substances Interferons. Ribavirin inhibits viral-induced macrophage production of TNF, IL-1, the procoagulant fgl2 prothrombinase and preserves Th1 cytokine production but inhibits Th2 cytokine response. The heart sounds were feeble. Skip Nav Destination Article Navigation. Massive weight gain is rarely associated with hypothyroidism. Nevertheless, the remarkable variation in the prevalence of IFN-related thyroid disease may also reflect variable individual predisposition to the disease.

A metaanalysis of the literature by Koh et al. However, the presence of the ajd and signs of thyrotoxicosis should alert treatment of interferon induced hypothyroidism and weight physician to evaluate thyroid function. The thyroid gland is a butterfly-shaped endocrine gland that is…. 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. Prevention of lymphocytic thyroiditis in iodide-treated non-obese diabetic mice lacking interferon regulatory factor

Females were at higher risk. J Clin Endocrinol Metab 80 : — Published 02 Sep

Effect of interferon- therapy on epitome-specific cytotoxic T lymphocyte responses in hepatitis C virus-infected individuals. Temporal relationship between the appearance of thyroid autoantibodies and development of destructive thyroiditis in patients undergoing treatment with two treatment of interferon induced hypothyroidism and weight type-1 interferons for HCV-related chronic hepatitis: a prospective study. IFN treatment of cultured thyrocytes induces increased expression of thyroglobulin, sodium-iodide symporters, TSH receptors, and thyroid peroxidase [ 34 ]. However, a recent study from Italy showing a significant association between lower serum CXCL10 levels and the development of IIT, suggested that this might be a useful predictive test Thyroid dysfunction in hepatitis C individuals treated with interferon-alpha and ribavirin: a review. Ribavirin polarizes human T cell responses toward a type 1 cytokine profile.

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A genetic predisposition to thyroid autoimmune and weight is probably necessary for the development of thyroid disease in patients treated with IFN 27 — Dai et al. The diagnosis of thyrotoxicosis was confirmed: TSH was 0. Although it is uncertain whether TPOAbs have a major pathophysiological role in inducing hypothyroidism 83it has been suggested that these antibodies reflect a more advanced and aggressive underlying autoimmune destructive process of the thyroid gland 2984 — George, and N. As a service to our customers we are providing this early version of the manuscript.

Bim EJ, Mehandru S. The critical point is to understand how a generalized activation of the immune system, induced by the cytokine treatment, may result in an organ-specific involvement of the thyroid gland. It is seen more frequently in patients on IFN-alpha with chronic HCV infection than in chronic hepatitis B infection, suggesting a synergistic role of HCV and IFN-alpha [ 2 ], HCV may result in an induction of IFN in the thyroid gland which activates natural killer cells, leading to proliferation of memory T cells and prevention of apoptosis, thus raising the thyroid auto-antibodies titer. As indicated earlier, the factors that control our appetite, metabolism, and activity are very complex and thyroid hormone is only one factor in this complex system. Advance article alerts. A Prospective Cohort Study.

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