Silvestri F, Virgolini L, Mazzolini A, Bertolissi F, Russo D, Fanin R, Baccarani M
Department of Medical and Morphological Research, Udine University School of Medicine, Italy.
Haematologica. 1994 Jul-Aug;79(4):367-70.
In recent years recombinant alpha-interferons (alpha-IFNs) have been widely used in the treatment of several hematological malignancies. Prolonged courses of IFN have been shown to induce autoantibodies and to support the exacerbation or even the development of autoimmune diseases. In this report we describe the development of symptomatic autoimmune thyroid diseases in 4 (7.4%) out of 54 patients in chronic treatment with recombinant alpha-IFNs in our department. Two patients developed a disease resembling Hashimoto's thyroiditis after 17 and 49 months of continuous IFN treatment, while the other two developed a typical Graves' disease after 41 and 52 months of therapy. The mechanism by which IFN induces autoimmune thyroid diseases, the choice of searching for anti-thyroid autoantibodies before starting long-term IFN treatment, the option of discontinuing IFN therapy in the presence of overt thyroid diseases, and the management of these diseases are discussed.
近年来，重组α干扰素（α-IFN）已广泛应用于多种血液系统恶性肿瘤的治疗。长期使用干扰素已被证明可诱导自身抗体，并促使自身免疫性疾病恶化甚至发展。在本报告中，我们描述了在我们科室接受重组α干扰素长期治疗的54例患者中，有4例（7.4%）出现了症状性自身免疫性甲状腺疾病。2例患者在持续使用干扰素治疗17个月和49个月后出现了类似桥本甲状腺炎的疾病，而另外2例患者在治疗41个月和52个月后出现了典型的格雷夫斯病。本文讨论了干扰素诱导自身免疫性甲状腺疾病的机制、在开始长期干扰素治疗前筛查抗甲状腺自身抗体的选择、在出现明显甲状腺疾病时停用干扰素治疗的选择以及这些疾病的管理。
