Thyrotoxicosis induced by alpha-interferon therapy in chronic viral hepatitis
Volume 56 Issue 6 Page 793 - June 2002
Thyrotoxicosis induced by alpha-interferon therapy in chronic viral
Vincent Wong*, Angela Xi-Li Fu*, Jacob George and N. Wah Cheung*
background and objectiveIt has been well documented that treatment of
chronic hepatitis B and C infection with interferon alpha (IFN-) can
lead to the induction of thyroid autoantibodies and hypothyroidism.
Thyrotoxicosis, however, is less frequently observed and less well
patients and methodsWe reviewed the medical records of patients who
developed thyrotoxicosis while receiving IFN- for either chronic
hepatitis B or C infection at Westmead Hospital between 1996 and
resultsTen patients (four males and six females) were found to have
biochemical thyrotoxicosis. The patients could be divided into two
groups with different characteristics. The first group consisted of
six patients who had clinical manifestations consistent with Graves
disease, with either diffuse uptake in thyroid scintigraphy and/or
positive thyroid-stimulating antibodies. They all required prolonged
treatment with antithyroid medications. The second group included
three patients who had transient thyrotoxicosis, with progression to
hypothyroidism after resolution of thyrotoxicosis.
conclusionOur study suggests that IFN therapy may provoke two
different forms of thyrotoxicosis: a Graves disease picture or a
biphasic thyroiditis pattern. The two entities should be
differentiated, as they have different implications for treatment.
Angela Xi-Li Fu
N. Wah Cheung
*Department of Diabetes and Endocrinology, Westmead Hospital and
Storr Liver Unit, Westmead Millennium Institute, University of
Sydney, Westmead Hospital, NSW, Australia
Correspondence: Dr Vincent Wong, Department of Diabetes and
Endocrinology, Westmead Hospital, Hawkesbury Road, Westmead, NSW
2145, Australia. Fax: (612) 9635 5691; E-mail: swavwong@...
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