Tran Huy A, Reeves Glenn Em
Department of Clinical Chemistry and University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, New South Wales 2310, Australia.
Thyroid Res. 2009 Dec 2;2(1):12. doi: 10.1186/1756-6614-2-12.
Hepatitis C virus is a highly immunogenic pathogen often inducing autoimmune activation changes and this can often be further exacerbated by Interferon therapy. As HCV is lymphocytotropic, it can modulate T cell and B cell antibody responses, affecting many endocrine organs, most commonly the thyroid.
We hereby describe a case of fluctuating and wavering thyrotropin autoantibodies of both stimulating and blocking nature in the setting of Graves's ophthalmopathy, hepatitis C infection and interferon-alpha, causing hypo- and subsequently hyper-thyroidism. The autoantibody profile was clearly modified during interferon therapy and settled into a new equilibrium at the completion of treatment.
The case highlights the possible existence of a dual thyroid autoantibody population associated with hepatitis C, and its modulation by interferon therapy, which further compounds the difficulties in the assessment thyroid disease in this setting.
丙型肝炎病毒是一种具有高度免疫原性的病原体，常引发自身免疫激活变化，而干扰素治疗往往会使其进一步加剧。由于丙型肝炎病毒具有嗜淋巴细胞性，它可调节T细胞和B细胞抗体反应，影响许多内分泌器官，最常见的是甲状腺。
我们在此描述一例在格雷夫斯眼病、丙型肝炎感染和α干扰素治疗背景下出现具有刺激和阻断性质的促甲状腺素自身抗体波动的病例，该病例导致甲状腺功能减退继而甲状腺功能亢进。自身抗体谱在干扰素治疗期间明显改变，并在治疗结束时达到新的平衡。
该病例突出了与丙型肝炎相关的双重甲状腺自身抗体群体可能存在，以及其受干扰素治疗的调节，这进一步增加了在此情况下评估甲状腺疾病的难度。
