The natural history of interferon-2b-induced thyroiditis and its exclusivity in a cohort of patients with chronic hepatitis C infection

[Guest guest]

http://qjmed.oxfordjournals.org/cgi/content/abstract/hcn150 QJM Advance Access

published online on November 25, 2008 QJM, doi:10.1093/qjmed/hcn150 The natural

history of interferon-2b-induced thyroiditis and its exclusivity in a cohort of

patients with chronic hepatitis C infection H.A. Tran1, G.E.M. Reeves1 and T.L.

2 From the 1Hunter Area Pathology Service, Newcastle University and

2Hepatitis C Service, Gastroenterology Department, Hunter Hospital, Locked

Bag Number 1, Hunter Mail Region Centre, Newcastle, New South Wales 2310,

Australia Address correspondence to H.A. Tran, Hunter Area Pathology Service,

Hunter Hospital, Locked Bag Number 1, Hunter Mail Region Centre, Newcastle,

New South Wales 2310, Australia. email: huy.tran@... Received

8 August 2008 and in revised form 13 October 2008 Abstract Background:

Interferon-2b (IFN-2b) is well known to cause both hyper- and hypo-thyroidism.

In the former, the commonest aetiology is thyroiditis. As there is no previous

data to fully characterize the entity of IFN-related thyroiditis, the aim of

this study is to document in detail its evolution in a cohort of hepatitis C

patients treated with pegylated IFN-2b and Ribavirin (RBV). Methods: A

prospective observational study was conducted in patients who developed thyroid

diseases whilst receiving combination of pegylated IFN-2b and RBV for hepatitis

C. The patients were followed with monthly thyrotropin (TSH). Where TSH was

undetectable, free tetra- (fT4) and tri-iodothyronine (fT3) were added.

Anti-thyroperoxidase (TPO), anti-thyroglobulin (Tg) and thyroid stimulating

immunoglobulin (TSI) levels were also performed at diagnosis, during and at the

end of IFN therapy. All patients were assessed and followed up closely with

monthly TSH, fT4 and fT3 levels until the completion, after 6 and 12 months of

treatment. Results: There were seven females and four males over a 30-month

period. All patients were found to have thyroiditis. On average, the time to the

development of thyroid disease was 10 weeks and duration of disease 9 weeks. All

patients eventually recovered normal biochemical thyroid function although two

required short-term supplementation. Conclusions: Thyroiditis was found

exclusively in our patients. Both the hyper- and hypo-thyroid phase can be short

lived, extreme and transient in nature which warrants strict monthly TSH

monitoring. Careful follow-up of all patients is mandatory as complete recovery

is expected.

[Guest guest]

http://qjmed.oxfordjournals.org/cgi/content/abstract/hcn150 QJM Advance Access

published online on November 25, 2008 QJM, doi:10.1093/qjmed/hcn150 The natural

history of interferon-2b-induced thyroiditis and its exclusivity in a cohort of

patients with chronic hepatitis C infection H.A. Tran1, G.E.M. Reeves1 and T.L.

2 From the 1Hunter Area Pathology Service, Newcastle University and

2Hepatitis C Service, Gastroenterology Department, Hunter Hospital, Locked

Bag Number 1, Hunter Mail Region Centre, Newcastle, New South Wales 2310,

Australia Address correspondence to H.A. Tran, Hunter Area Pathology Service,

Hunter Hospital, Locked Bag Number 1, Hunter Mail Region Centre, Newcastle,

New South Wales 2310, Australia. email: huy.tran@... Received

8 August 2008 and in revised form 13 October 2008 Abstract Background:

Interferon-2b (IFN-2b) is well known to cause both hyper- and hypo-thyroidism.

In the former, the commonest aetiology is thyroiditis. As there is no previous

data to fully characterize the entity of IFN-related thyroiditis, the aim of

this study is to document in detail its evolution in a cohort of hepatitis C

patients treated with pegylated IFN-2b and Ribavirin (RBV). Methods: A

prospective observational study was conducted in patients who developed thyroid

diseases whilst receiving combination of pegylated IFN-2b and RBV for hepatitis

C. The patients were followed with monthly thyrotropin (TSH). Where TSH was

undetectable, free tetra- (fT4) and tri-iodothyronine (fT3) were added.

Anti-thyroperoxidase (TPO), anti-thyroglobulin (Tg) and thyroid stimulating

immunoglobulin (TSI) levels were also performed at diagnosis, during and at the

end of IFN therapy. All patients were assessed and followed up closely with

monthly TSH, fT4 and fT3 levels until the completion, after 6 and 12 months of

treatment. Results: There were seven females and four males over a 30-month

period. All patients were found to have thyroiditis. On average, the time to the

development of thyroid disease was 10 weeks and duration of disease 9 weeks. All

patients eventually recovered normal biochemical thyroid function although two

required short-term supplementation. Conclusions: Thyroiditis was found

exclusively in our patients. Both the hyper- and hypo-thyroid phase can be short

lived, extreme and transient in nature which warrants strict monthly TSH

monitoring. Careful follow-up of all patients is mandatory as complete recovery

is expected.

[Guest guest]

http://qjmed.oxfordjournals.org/cgi/content/abstract/hcn150 QJM Advance Access

published online on November 25, 2008 QJM, doi:10.1093/qjmed/hcn150 The natural

history of interferon-2b-induced thyroiditis and its exclusivity in a cohort of

patients with chronic hepatitis C infection H.A. Tran1, G.E.M. Reeves1 and T.L.

2 From the 1Hunter Area Pathology Service, Newcastle University and

2Hepatitis C Service, Gastroenterology Department, Hunter Hospital, Locked

Bag Number 1, Hunter Mail Region Centre, Newcastle, New South Wales 2310,

Australia Address correspondence to H.A. Tran, Hunter Area Pathology Service,

Hunter Hospital, Locked Bag Number 1, Hunter Mail Region Centre, Newcastle,

New South Wales 2310, Australia. email: huy.tran@... Received

8 August 2008 and in revised form 13 October 2008 Abstract Background:

Interferon-2b (IFN-2b) is well known to cause both hyper- and hypo-thyroidism.

In the former, the commonest aetiology is thyroiditis. As there is no previous

data to fully characterize the entity of IFN-related thyroiditis, the aim of

this study is to document in detail its evolution in a cohort of hepatitis C

patients treated with pegylated IFN-2b and Ribavirin (RBV). Methods: A

prospective observational study was conducted in patients who developed thyroid

diseases whilst receiving combination of pegylated IFN-2b and RBV for hepatitis

C. The patients were followed with monthly thyrotropin (TSH). Where TSH was

undetectable, free tetra- (fT4) and tri-iodothyronine (fT3) were added.

Anti-thyroperoxidase (TPO), anti-thyroglobulin (Tg) and thyroid stimulating

immunoglobulin (TSI) levels were also performed at diagnosis, during and at the

end of IFN therapy. All patients were assessed and followed up closely with

monthly TSH, fT4 and fT3 levels until the completion, after 6 and 12 months of

treatment. Results: There were seven females and four males over a 30-month

period. All patients were found to have thyroiditis. On average, the time to the

development of thyroid disease was 10 weeks and duration of disease 9 weeks. All

patients eventually recovered normal biochemical thyroid function although two

required short-term supplementation. Conclusions: Thyroiditis was found

exclusively in our patients. Both the hyper- and hypo-thyroid phase can be short

lived, extreme and transient in nature which warrants strict monthly TSH

monitoring. Careful follow-up of all patients is mandatory as complete recovery

is expected.

[Guest guest]

http://qjmed.oxfordjournals.org/cgi/content/abstract/hcn150 QJM Advance Access

published online on November 25, 2008 QJM, doi:10.1093/qjmed/hcn150 The natural

history of interferon-2b-induced thyroiditis and its exclusivity in a cohort of

patients with chronic hepatitis C infection H.A. Tran1, G.E.M. Reeves1 and T.L.

2 From the 1Hunter Area Pathology Service, Newcastle University and

2Hepatitis C Service, Gastroenterology Department, Hunter Hospital, Locked

Bag Number 1, Hunter Mail Region Centre, Newcastle, New South Wales 2310,

Australia Address correspondence to H.A. Tran, Hunter Area Pathology Service,

Hunter Hospital, Locked Bag Number 1, Hunter Mail Region Centre, Newcastle,

New South Wales 2310, Australia. email: huy.tran@... Received

8 August 2008 and in revised form 13 October 2008 Abstract Background:

Interferon-2b (IFN-2b) is well known to cause both hyper- and hypo-thyroidism.

In the former, the commonest aetiology is thyroiditis. As there is no previous

data to fully characterize the entity of IFN-related thyroiditis, the aim of

this study is to document in detail its evolution in a cohort of hepatitis C

patients treated with pegylated IFN-2b and Ribavirin (RBV). Methods: A

prospective observational study was conducted in patients who developed thyroid

diseases whilst receiving combination of pegylated IFN-2b and RBV for hepatitis

C. The patients were followed with monthly thyrotropin (TSH). Where TSH was

undetectable, free tetra- (fT4) and tri-iodothyronine (fT3) were added.

Anti-thyroperoxidase (TPO), anti-thyroglobulin (Tg) and thyroid stimulating

immunoglobulin (TSI) levels were also performed at diagnosis, during and at the

end of IFN therapy. All patients were assessed and followed up closely with

monthly TSH, fT4 and fT3 levels until the completion, after 6 and 12 months of

treatment. Results: There were seven females and four males over a 30-month

period. All patients were found to have thyroiditis. On average, the time to the

development of thyroid disease was 10 weeks and duration of disease 9 weeks. All

patients eventually recovered normal biochemical thyroid function although two

required short-term supplementation. Conclusions: Thyroiditis was found

exclusively in our patients. Both the hyper- and hypo-thyroid phase can be short

lived, extreme and transient in nature which warrants strict monthly TSH

monitoring. Careful follow-up of all patients is mandatory as complete recovery

is expected.