Department of Medicine, Division of Endocrinology, Mount Sinai School of Medicine, Box 1118, One Gustave L. Levy Place, New York, NY 10029, USA.
Best Pract Res Clin Endocrinol Metab. 2009 Dec;23(6):703-12. doi: 10.1016/j.beem.2009.07.004.
Interferon-alpha (IFNalpha) is used for the treatment of various disorders, most notable chronic hepatitis C virus (HCV) infection. One of the commonest side effects of IFNalpha therapy is thyroiditis, with up to 40% of HCV patients on IFNalpha developing clinical or subclinical disease. In some cases interferon induced thyroiditis (IIT) may result in severe symptomatology necessitating discontinuation of therapy. IIT can manifest as clinical autoimmune thyroiditis, presenting with symptoms of classical Hashimoto's thyroiditis or Graves' disease, or as non-autoimmune thyroiditis. Non-autoimmune thyroiditis can manifest as destructive thyroiditis, with early thyrotoxicosis and later hypothyroidism, or as non-autoimmune hypothyroidism. While the epidemiology and clinical presentation of IIT have been well characterized the mechanisms causing IIT are still poorly understood. It is likely that the hepatitis C virus (HCV) itself plays a role in the disease, as the association between HCV infection and thyroiditis is well established. It is believed that IFNalpha induces thyroiditis by both immune stimulatory effects and by direct effects on the thyroid. Early detection and therapy of this condition are important in order to avoid complications of thyroid disease such as cardiac arrhythmias.
干扰素-α（IFNalpha）用于治疗各种疾病，最显著的是慢性丙型肝炎病毒（HCV）感染。IFNalpha 治疗最常见的副作用之一是甲状腺炎，高达 40%的 HCV 患者出现临床或亚临床疾病。在某些情况下，干扰素诱导的甲状腺炎（IIT）可能导致严重的症状，需要停止治疗。IIT 可表现为临床自身免疫性甲状腺炎，表现为经典桥本甲状腺炎或格雷夫斯病的症状，或表现为非自身免疫性甲状腺炎。非自身免疫性甲状腺炎可表现为破坏性甲状腺炎，早期甲状腺功能亢进，后期甲状腺功能减退，或表现为非自身免疫性甲状腺功能减退。虽然 IIT 的流行病学和临床表现已经得到很好的描述，但导致 IIT 的机制仍知之甚少。丙型肝炎病毒（HCV）本身可能在疾病中起作用，因为 HCV 感染与甲状腺炎之间的关联已得到充分证实。据信，IFNalpha 通过免疫刺激作用和对甲状腺的直接作用引起甲状腺炎。早期发现和治疗这种情况非常重要，以避免甲状腺疾病的并发症，如心律失常。
