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在接受干扰素-β治疗的多发性硬化症患者中,为期九个月的随访期间甲状腺自身免疫和功能障碍的发生情况。

Occurrence of thyroid autoimmunity and dysfunction throughout a nine-month follow-up in patients undergoing interferon-beta therapy for multiple sclerosis.

作者信息

Rotondi M, Oliviero A, Profice P, Mone C M, Biondi B, Del Buono A, Mazziotti G, Sinisi A M, Bellastella A, Carella C

机构信息

Institute of Endocrinology, II University of Napoli, Italy.

出版信息

J Endocrinol Invest. 1998 Dec;21(11):748-52. doi: 10.1007/BF03348040.

Abstract

Thyroid autoimmunity and dysfunction are a well known side effect of IFN alpha therapy for viral hepatitis and tumors, while the IFN beta effects on the thyroid gland in neurological patients have not been studied. The aim of this longitudinal study was to look for the appearance of thyroid autoimmunity as well as for the occurrence of overt thyroid disease in the patients affected by multiple sclerosis (MS) treated with IFN beta 1b. Eight patients (4 males, 4 females) undergoing r-IFN beta 1b treatment (8 M.U. every other day for 9 months) for relapsing remitting multiple sclerosis entered the study. We have analyzed thyroid function parameters and auto antibody levels before and after 1, 2, 3, 6 and 9 months of therapy. None of them referred to familiar thyroid pathology or presented clinically overt thyroid disease except for one patient (case 4) who showed TPO-Ab pretreatment positivity and another (case 8) who was in therapy with Levothyroxine 100 microg/die for multinodular goiter. The number of patients with appearance of thyroid antibodies has slowly increased, until the third month of therapy with 3 patients out of 7 positive for TPO-Ab. The only case of overt thyroid dysfunction reported by us appeared after nine months of therapy and consisted of a hypothyroidism. Our data suggest that short-term interferon beta treatment is able to induce thyroid autoimmunity (42.8%) and dysfunction (12.5%).

摘要

甲状腺自身免疫和功能障碍是干扰素α治疗病毒性肝炎和肿瘤时众所周知的副作用,而干扰素β对神经疾病患者甲状腺的影响尚未得到研究。这项纵向研究的目的是探寻在用β-1b干扰素治疗的多发性硬化症(MS)患者中甲状腺自身免疫的出现情况以及显性甲状腺疾病的发生情况。八名复发缓解型多发性硬化症患者(4名男性,4名女性)接受了重组β-1b干扰素治疗(每隔一天8百万单位,共9个月)并进入该研究。我们分析了治疗1、2、3、6和9个月前后的甲状腺功能参数和自身抗体水平。除了一名患者(病例4)治疗前TPO-Ab呈阳性,另一名患者(病例8)因多结节性甲状腺肿正在接受每天100微克左甲状腺素治疗外,他们均未提及家族性甲状腺病变或表现出临床显性甲状腺疾病。出现甲状腺抗体的患者数量缓慢增加,直至治疗第三个月时,7名患者中有3名TPO-Ab呈阳性。我们报告的唯一一例显性甲状腺功能障碍出现在治疗九个月后,为甲状腺功能减退。我们的数据表明,短期干扰素β治疗能够诱发甲状腺自身免疫(42.8%)和功能障碍(12.5%)。

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