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Graves' Disease in Interferon-α-Treated and Untreated Patients with Chronic Hepatitis C Virus Infection
  1. Roberta Minelli,
  2. Vittorio Coiro,
  3. Maria Antonietta Valli,
  4. Lorenzo Finardi,
  5. Clelia Di Seclì,
  6. Roberto Bertoni,
  7. Daniele La Gioia,
  8. Angela Luciana Barilli,
  9. Carlo Ferrari,
  10. Gloria Saccani Jotti,
  11. Roberto Delsignore
  1. From the Cattedra di Endocrinologia (R.M., L.F., C.D.S.), Dipartimento di Medicina Interna e Scienze Biomediche (V.C., D.L.G., A.L.B., R.D.), Dipartimento di Sanità Pubblica (G.S.J.), Università degli Studi di Parma, Parma, Italy; Divisione di Malattie Infettive (M.A.V., R.B., C.F.), Azienda Ospedaliera di Parma, Parma, Italy.
  1. Address correspondence to: Prof. Roberta Minelli, Cattedra di Endocrinologia, Via Gramsci 14, 43100 Parma, Italy; e-mail: roberta.minelli{at}unipr.it.

Abstract

An association between Graves' disease (GD) and chronic hepatitis C (C-HC) has been observed both in the presence and the absence of recombinant interferon-α (rIFN-α) treatment. rIFN-α-induced GD is characterized by suppressed thyroid-stimulating hormone levels; normal or elevated free triiodothyronine (FT3) and free thyroxine (FT4) values; the presence of thyroid peroxidase antibodies, antithyroglobulin antibodies, and thyroid receptor antibodies; and high iodine thyroid uptake. In contrast, GD developed during C-HC without rIFN-α is less clearly defined. In this study, we examined two groups of patients: group A, 28 patients with C-HC treated with rIFN-α who developed GD after 1 to 9 months, and group B, 10 patients with C-HC who developed GD without a previous rIFN-α treatment. At the time of GD, both groups started methimazole therapy; thyroid function was reevaluated after 3, 6, 9, and 12 months. Group A patients continued IFN. After 12 months, all patients of group A were euthyroid, and 21 of them (75%) had already stopped methimazole treatment, whereas all patients of group B were euthyroid and only 2 (20%) had stopped methimazole. In conclusion, the data show a better course of GD, with a more precocious and significantly higher number of recoveries in patients with rIFN-α-induced GD than in rIFN-α-unrelated disease. Further studies are needed to establish whether the two types of GD differ not only from a clinical point of view but also because of different underlying pathogenetic mechanisms.

  • chronic hepatitis C
  • Graves' disease
  • interferon therapy

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