Environmental triggers of thyroiditis: Hepatitis C and interferon-α

F. Menconi, A. Hasham, Yaron Tomer

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Autoimmune thyroid diseases (AITD) are postulated to develop as a result of a complex interplay between several genetic and environmental influences. The pathogenesis of AITD is still not clearly defined. However, among the implicated triggers (e.g. iodine, infections, medications), more recent data confirmed strong associations of AITD with the hepatitis C virus (HCV) infection and interferon-α (IFNα) therapy. Moreover, it is likely that HCV and IFN act in synergism to trigger AITD in patients. Indeed, approximately 40% of HCV patients develop either clinical or subclinical disease while receiving IFNα. Interferon induced thyroiditis (IIT) can manifest as non-autoimmune thyroiditis (presenting as destructive thyroiditis, or non-autoimmune hypothyroidism), or autoimmune thyroiditis [presenting with clinical features of Graves' disease (GD) or Hashimoto's thyroiditis (HT)]. Although not yet clearly understood, it is thought that IFNα can induce thyroiditis via both immune stimulatory and direct toxic effects on the thyroid. In view of the high frequency of IIT, routine screening and surveillance of HCV patients receiving IFNα is recommended to avoid the complications, such as cardiac arrhythmias, associated with thyrotoxicosis. In summary, IIT is a common clinical problem that can be readily diagnosed with routine thyroid function screening of HCV patients receiving IFN. The treatment of IIT consists of the standard therapy for differing clinical manifestations of IIT such as GD, HT, or destructive thyroiditis. However, anti-thyroid medications are not recommended in this setting since they can potentially be hepatotoxic.

Original languageEnglish (US)
Pages (from-to)78-84
Number of pages7
JournalJournal of Endocrinological Investigation
Volume34
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Fingerprint

Thyroiditis
Hepatitis C
Interferons
Hepacivirus
Thyroid Diseases
Autoimmune Diseases
Hashimoto Disease
Thyroid Gland
Graves Disease
Autoimmune Thyroiditis
Thyrotoxicosis
Poisons
Virus Diseases
Hypothyroidism
Iodine
Cardiac Arrhythmias
Therapeutics

Keywords

  • Autoimmunity
  • Hepatitis C
  • Infection
  • Interferon
  • Thyroiditis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Environmental triggers of thyroiditis : Hepatitis C and interferon-α. / Menconi, F.; Hasham, A.; Tomer, Yaron.

In: Journal of Endocrinological Investigation, Vol. 34, No. 1, 01.2011, p. 78-84.

Research output: Contribution to journalArticle

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