Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam.
Singapore Med J. 2011 Feb;52(2):e20-2.
A combination of pegylated interferon and ribavarin is currently the gold standard for the treatment of chronic hepatitis C infection. Interferon therapy can lead to the development of an autoimmune phenomenon that can be sub-clinical or clinical, and the presence of autoantibodies increases the risk. Thyroiditis is the most common autoimmune manifestation of interferon therapy and can present during treatment or after the completion of treatment. On the other hand, psoriasis is rare, and has been reported to occur within weeks of starting the treatment. We report a case of a 46-year-old indigen woman who was positive for multiple autoantibodies, and developed autoimmune thyroiditis that manifested as hypothyroidism during pegylated interferon and ribavarin therapy for chronic hepatitis C infection. She also developed plaque psoriasis after the completion of therapy. In our case, the association with thyroiditis was definite, whereas that with psoriasis was less definite. However, it is still important for clinicians to be aware of such rare associations.
聚乙二醇干扰素联合利巴韦林目前是慢性丙型肝炎感染治疗的金标准。干扰素治疗可导致自身免疫现象的发生，这种自身免疫现象可以是亚临床的，也可以是临床的，而自身抗体的存在会增加这种风险。甲状腺炎是干扰素治疗最常见的自身免疫表现形式，可在治疗期间或治疗结束后出现。另一方面，银屑病较为罕见，有报道称在开始治疗后数周内发生。我们报告了一例 46 岁的印第安妇女，她患有多种自身抗体，在接受聚乙二醇干扰素和利巴韦林治疗慢性丙型肝炎感染期间发生自身免疫性甲状腺炎，表现为甲状腺功能减退。治疗结束后，她还出现了斑块状银屑病。在我们的病例中，甲状腺炎的相关性是明确的，而银屑病的相关性则不那么明确。然而，临床医生仍然需要意识到这种罕见的关联。
