慢性丙型肝炎患者中干扰素α诱导的甲状腺功能障碍：一种短暂、可逆且自限性的功能障碍。

Interferon-alpha-induced thyroid dysfunction in patients with chronic active hepatitis C: a transient, reversible and self-limited dysfunction.

作者信息

Tsuboi K, Katayama M, Yuasa R, Matoba H, Nagayama T, Ihara F, Ooya T, Matsuo K, Otsuka S, Miyachi Y

机构信息

First Department of Internal Medicine, Toho University School of Medicine, Tokyo.

出版信息

Intern Med. 1998 Jan;37(1):27-31. doi: 10.2169/internalmedicine.37.27.

DOI:10.2169/internalmedicine.37.27

PMID:9510396

Abstract

To survey the prognoses of interferon-alpha (IFNalpha)-induced thyroid dysfunction, a total of 100 patients (49 males and 51 females) with biopsy-proven chronic active hepatitis C were studied. Either during or after IFNalpha therapy, 29 patients (33.7%) revealed suppression/elevation of thyroid stimulating hormone (TSH) or both, transient thyrotoxicosis (TSH less than 0.1 microU/ml) or transient hypothyroidism (TSH 5.0-190.95 microU/ml). However, the thyroid function normalized without supplementation of the thyroid hormone in the follow-up period. In the same period, one of the 14 control patients (7.1%) developed thyroid dysfunction. Thyroid abnormalities developed significantly more in patients with IFNalpha therapy than in those without IFNalpha therapy. The findings suggest that the occult autoimmune disorder becomes overt with IFNalpha treatment in patients with pre-existent autoimmune thyroid disease. IFNalpha-induced thyroid dysfunction is transient, reversible and self-limited. It is not necessary to discontinue IFNalpha therapy when thyroid dysfunction develops.

摘要

为了调查α干扰素（IFNα）诱导的甲状腺功能障碍的预后情况，我们对100例经活检证实为慢性丙型活动性肝炎的患者（49例男性和51例女性）进行了研究。在IFNα治疗期间或之后，29例患者（33.7%）出现促甲状腺激素（TSH）抑制/升高或两者兼有，短暂性甲状腺毒症（TSH小于0.1微单位/毫升）或短暂性甲状腺功能减退（TSH为5.0 - 190.95微单位/毫升）。然而，在随访期间甲状腺功能在未补充甲状腺激素的情况下恢复正常。同期，14例对照患者中有1例（7.1%）出现甲状腺功能障碍。接受IFNα治疗的患者甲状腺异常的发生率明显高于未接受IFNα治疗的患者。这些发现表明，在已有自身免疫性甲状腺疾病的患者中，隐匿性自身免疫性疾病在IFNα治疗后会变得明显。IFNα诱导的甲状腺功能障碍是短暂的、可逆的和自限性的。当出现甲状腺功能障碍时，没有必要停止IFNα治疗。