تحت درمان با آلفا اينترفرون C,B بررسي اختلالات عملكرد تيروييد در بيماران مبتلا به هپاتيت مزمن ويران

Assessment of thyroid gland of function during interferon alfa therapy in patients with HBV or HCV

Aim: To evaluate thyroid gland dysfunction during interferon alfa (INF-alpha) therapy in patients with the hepatitis B ( HBV) and hepatitis C virus (HCV) {BR}, Materials and Methods: 58 patients HCV and 18 patients with HBV were studied prospectively before and at 2 months intervals during INF-alpha therapy. Measurements of serum thyroxine, triiodothyronine, thyrotropine, triiodothyronine resin uptake, thyroid peroxidase antibodies (TPOAbs), and thyroglobulin antibodies (TgAbs) were obtained as were. Thyroid radioactive ioidine uptakes (RAlU) in patients who developed thyroxicosis. Thyroid gland size was evaluated with palpation. {BR) Results: All patients were clinically and biochemically euthyroid prior to INF-alpha therapy. Before treatment, positive levels of TPOAbs and TgAbs were found in 13.8% and 8.6% of patients with HCV compared with 5.5% and 5.5% of patients with HBV, respectively. Titres of TPOAbs increased significantly at the end of lNF -alpha therapy in patients with HCV (10.3%), among whom 5 patients developed hypothyroidism and 1 patient becamed thyrotoxic secondary to thyroiditis with low thyroid RAlU. Patients who developed thyroid gland dysfunction had a higher prevalence of TPOAbs before treatment. Thyroid gland size increased significantly during the study in patients with HBV (p<0.001) and HCV (p<0.005) respectively. {BR). Conclusions: Thyroid gland dysfunction is not infrequently observed in patients with HCV receiving INF alpha therapy. Systematic screening of thyroid function and TPOAbs titers in all patients with HCV before and during INF-alpha therapy seems warranted are recommended, should INF-alpha have goiterogenic effects; further studies are recommended.