QJM Advance Access published online on October 28, 2009
QJM, doi:10.1093/qjmed/hcp157
© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
The swinging thyroid in hepatitis C infection and interferon therapy
From the Hunter Area Pathology Service and Newcastle University, Locked Bag No. 1, Hunter Mail Region Centre, Newcastle, New South Wales 2310, Australia
Address correspondence to Prof. Huy A. Tran, Department of Clinical Chemistry, Hunter Area Pathology Service and Newcastle University, Locked Bag No. 1, Hunter Mail Region Centre, Newcastle, New South Wales 2310, Australia. Tel: +61-2-4921-4005; Fax: +61-2-4921-4440; email: huy.tran@hnehealth.nsw.gov.au
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Introduction |
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Thyroid diseases are the commonest endocrine manifestations in chronic hepatitis C infection. These are further exacerbated with the use of interferon-
related therapy. Beside the non-specific non-thyroidal illness, the spectrum of thyroid diseases range from frank hypothyroidism to overt thyroiditis. The latter is a specific condition in which there is a particular pattern of an initial thyrotoxicosis, followed by hypothyroidism with subsequent normalization, commonly known as biphasic thyroiditis. Presented is a case of tri-phasic thyroid response in which the interferon-induced bi-phasic thyroiditis was followed closely with Graves’ like thyrotoxicosis post therapy. This case offers a unique opportunity to understand the immunopathogenesis by analysis of the thyroid autoantibody pattern response. This is a recently described entity and the management needs to be specific for each particular phase of the condition.
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Clinical notes |
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A 53-year-old Caucasian man presented with acute thyroiditis whilst undergoing combination Ribavirin and Interferon-
2b therapy for his hepatitis C infection.