Baudin E, Marcellin P, Pouteau M, Colas-Linhart N, Le Floch J P, Lemmonier C, Benhamou J P, Bok B
Service de Médecine Nucléaire, Hôpital Beaujon, Université Paris 7, Clichy, France.
Clin Endocrinol (Oxf). 1993 Dec;39(6):657-61. doi: 10.1111/j.1365-2265.1993.tb02423.x.
Thyroid dysfunction has been reported as a complication of interferon therapy. The aim of our study was to assess the risk factors and reversibility of thyroid disorders induced by interferon therapy.
Prospective study.
A series of 68 patients with chronic hepatitis C completed a therapeutic trial of interferon alpha 2b (IFN), randomized for dose adaptation, lasting for 24 weeks.
TSH and autoantibodies against thyroid were looked for at (-2) weeks and 24 weeks in all patients. Blood samples obtained at (-2), 12, and 24 weeks were stored for additional hormonal studies in patients who developed thyroid dysfunction. Such patients with thyroid dysfunction were followed up for at least one year.
Only one out of 68 patients had abnormal TSH levels, and two had thyroid autoantibodies prior to interferon therapy. Eight patients (12%) developed thyroid dysfunction (five hypothyroidism and three hyperthyroidism) during treatment. In four patients (all of them with thyroid dysfunction, P < 0.001) antimicrosomal, antithyroglobulin, and/or anti-TSH receptor antibodies appeared during interferon therapy. All patients recovered normal thyroid function within 1.5 years after interferon withdrawal. No pretreatment risk factor was identified. The patients with thyroid dysfunction did not significantly differ from the others as regards the dose of interferon they received or the rate of normalization of transaminases.
(i) A 12% incidence of thyroid dysfunction was observed under interferon therapy; (ii) secondary appearance under interferon therapy of elevated thyroid autoantibodies was a risk factor; (iii) the thyroid disorders induced by interferon were reversible.
甲状腺功能障碍已被报道为干扰素治疗的一种并发症。我们研究的目的是评估干扰素治疗所致甲状腺疾病的危险因素及可逆性。
前瞻性研究。
68例慢性丙型肝炎患者完成了一项干扰素α2b（IFN）治疗试验，随机进行剂量调整，疗程为24周。
所有患者在第（-2）周和第24周检测促甲状腺激素（TSH）及甲状腺自身抗体。在第（-2）周、第12周和第24周采集的血样保存下来，用于发生甲状腺功能障碍患者的进一步激素研究。这些甲状腺功能障碍患者至少随访一年。
68例患者中只有1例在干扰素治疗前TSH水平异常，2例有甲状腺自身抗体。8例患者（12%）在治疗期间发生甲状腺功能障碍（5例甲状腺功能减退，3例甲状腺功能亢进）。4例患者（均有甲状腺功能障碍，P<0.001）在干扰素治疗期间出现微粒体抗体、甲状腺球蛋白抗体和/或促甲状腺激素受体抗体。所有患者在停用干扰素后1.5年内甲状腺功能恢复正常。未发现治疗前的危险因素。甲状腺功能障碍患者在接受的干扰素剂量或转氨酶正常化率方面与其他患者无显著差异。
（i）干扰素治疗期间甲状腺功能障碍的发生率为12%；（ii）干扰素治疗期间甲状腺自身抗体升高的继发性出现是一个危险因素；（iii）干扰素所致的甲状腺疾病是可逆的。
