J Korean Med Sci.  2011 Dec;26(12):1638-1641. 10.3346/jkms.2011.26.12.1638.

Interferon-Alpha-Induced Destructive Thyroiditis Followed by Graves' Disease in a Patient with Chronic Hepatitis C: A Case Report

Affiliations
  • 1Department of Internal Medicine, Kosin University, College of Medicine, Busan, Korea. yschoi@kosinmed.or.kr

Abstract

Interferon-induced thyroiditis (IIT) is a major clinical problem for patients receiving interferon-alpha (IFN-alpha) therapy. But, destructive thyroiditis followed by Graves' disease associated with IFN-alpha therapy is very rarely reported. Herein, we report a rare case of pegylated IFN-alpha (pegIFN-alpha) induced destructive thyroiditis followed by Graves' disease in a patient with HCV infection. A 31-yr-old woman suffered from chronic active hepatitis C and was treated with pegIFN-alpha and ribavirin for 12 months. Results of a thyroid function test and autoantibody levels were normal before IFN-alpha therapy was initiated. Destructive thyrotoxicosis appeared seven months after the initiation of IFN-alpha therapy, followed by Graves' thyrotoxicosis two months after the cessation of therapy. The diagnoses of destructive thyroiditis and Graves' disease were confirmed by the presence of TSH receptor antibodies in addition to Tc-99m scintigraphy findings. The patient's antithyroglobulin antibody titer increased gradually during IFN-alpha therapy and remained weakly positive after IFN-alpha therapy was discontinued.

Keyword

Interferons; Destructive Thyroiditis; Graves Disease

MeSH Terms

Adult
Antiviral Agents/*adverse effects/therapeutic use
Female
Graves Disease/*chemically induced
Hepatitis C, Chronic/*drug therapy
Humans
Interferon-alpha/*adverse effects/therapeutic use
Methimazole/therapeutic use
Propranolol/therapeutic use
Thyroiditis/*chemically induced

Figure

  • Fig. 1 Tc-99m scintigraphy showing non-visualization of the thyroid gland (A) and increased uptake throughout (B).

  • Fig. 2 Thyroid ultrasonography showing diffuse enlargement and coarse parenchyma of both thyroid gland (A) and increased vascularities (B).


Cited by  1 articles

Interferon-Alpha Induced Severe Hypothyroidism Followed by Graves' Disease in a Patient Infected with Hepatitis C Virus
Kyoung Jin Kim, Kang Won Lee, Ju Hee Choi, Jee Hyun An
Int J Thyroidol. 2015;8(2):230-234.    doi: 10.11106/ijt.2015.8.2.230.


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