Rashed Yasser K, Khalaf Fatma A, Kotb Sobhy E
Department of Pediatric Hepatology, National Liver Institute, Menoufia University, Menoufia, Egypt.
Department of Clinical Biochemistry, National Liver Institute, Menoufia University, Menoufia, Egypt.
Clin Exp Pediatr. 2020 Feb;63(2):52-55. doi: 10.3345/kjp.2018.07150. Epub 2020 Feb 6.
Immunomodulatory properties of interferon (IFN) have been documented. It may induce autoimmune diseases such as autoimmune thyroiditis with hypo- or hyperthyroidism. In addition, it may impair thyroid hormone synthesis through affecting iodide organification in thyroid gland.
The aim of this study was to describe thyroid function tests disturbances in children with chronic hepatitis C (CHC) receiving pegylated interferon-alpha (PEG IFN-α) plus ribavirin.
Fifty children with CHC virus infection who received combined pegylated interferon-alpha with ribavirin were selected. Other 50 apparently healthy children of matched age and sex (considered as control group) were selected. All children (100) were subject to liver function tests, virological studies, and follow-up of thyroid function test during and after the treatment course.
Our study showed that 28% of children received combined PEG IFN-α plus ribavirin showed subclinical hypothyroidism. After 24 weeks treatment with combined therapy of IFN plus ribavirin, the mean level of thyroid stimulating hormone (TSH) was 3.23±88 mU/mL, while TSH was 1.16± 0.77 mU/mL before starting treatment. On the other hand, mean TSH was 1.09±0.92 mU/mL in normal control group.
This study revealed an association between subclinical thyroid dysfunction and treatment with IFN-alpha and ribavirin in children. Further studies on larger number of patients and longer follow-up duration are recommended for further confirmation.
干扰素(IFN)的免疫调节特性已有文献记载。它可能诱发自身免疫性疾病,如伴有甲状腺功能减退或亢进的自身免疫性甲状腺炎。此外,它可能通过影响甲状腺中的碘有机化来损害甲状腺激素合成。
本研究的目的是描述接受聚乙二醇化干扰素-α(PEG IFN-α)加利巴韦林治疗的慢性丙型肝炎(CHC)儿童的甲状腺功能测试紊乱情况。
选取50例接受聚乙二醇化干扰素-α与利巴韦林联合治疗的CHC病毒感染儿童。另选取50例年龄和性别匹配的明显健康儿童(作为对照组)。所有100名儿童均接受肝功能测试、病毒学研究,并在治疗期间及治疗后对甲状腺功能测试进行随访。
我们的研究表明,接受PEG IFN-α加利巴韦林联合治疗的儿童中有28%出现亚临床甲状腺功能减退。在接受干扰素加利巴韦林联合治疗24周后,促甲状腺激素(TSH)的平均水平为3.23±88 mU/mL,而在开始治疗前TSH为1.16±0.77 mU/mL。另一方面,正常对照组的平均TSH为1.09±0.92 mU/mL。
本研究揭示了儿童亚临床甲状腺功能障碍与干扰素-α和利巴韦林治疗之间的关联。建议对更多患者进行进一步研究并延长随访时间以进一步证实。