Thyroiditis Associated With Peginterferon α-2A in a Patient with HBeAg Positive Chronic Hepatitis B
Journal Name:
- Abant Tıp Dergisi
Key Words:
Keywords (Original Language):
| Author Name | University of Author | Faculty of Author |
|---|---|---|
Abstract (2. Language):
Interferons are used to treat chronic viral hepatitis, due to
antiviral activity, are substances of protein structure. IF can
lead to disorders of thyroid function during their use for
treatment. PEG-IFN α-2a 120 mcg sc / week to thirty-threeyear-
old male patient was started with the diagnosis of
HBeAg (+) chronic hepatitis B. In the beginning of treatment,
thyroid stimulating hormone (TSH), free T3 (FT3), free T4
(FT4) levels were normal and antinuclear antibody (ANA)
was negative. In the sixth month of treatment the patient's;
TSH was 60.52 (↑), FT3 was 4.06 (N), FT4 was 4.48 (↓),
thyroglobulin (TG) was 1.6 ng / ml (N), anti-thyroglobulin
antibody (ATA) was 631 IU / ml (↑), anti-microsomal antibody
(AMA) was 1000IU/ml (↑). Thyroid ultrasonography
revealed bilateral hypoechoic fibrous septa (pseudolobulation)
and increased blood flow (Hashimoto's thyroiditis? ) in
the thyroid parenchyma. In Thyroid scintigraphy; nonhomogeneous
hyperplastic thyroid gland and hyperactive nodule
in left lobe were seen. The result of thyroid biopsy were
evaluated as benign cytology. Hashimoto's thyroiditis associated
with interferon was thought. Later, IFN therapy was
discontinued and lamivudine was started. Due to iatrogenic
hyperthyroidism for the patient, levotiron 1x1 was started.
In third months of levotiron therapy, TSH was 0.190, T3 was
5.6, T4 was 21: 24. Levotiron treatment was stopped. In 6
months after discontinuation of interferon therapy TSH was
0742, FT3 was 5: 33, FT4 was 14: 53. There was no thyroid
disfunction in follow-up of the patient.
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Abstract (Original Language):
İnterferon (IFN) lar antiviral etkinliğinden dolayı kronik viral
hepatit tedavisinde kullanılan protein yapıdaki maddelerdir.
Tedavi amacıyla kullanımları sırasında tiroid fonksiyon bozukluklarına
sebep olabilmektedirler. Otuz üç yaşında erkek
hastaya HBeAg (+) kronik hepatit B tanısıyla PEG- IFN α-2a
120 mcg s.c./hafta tedavisi başlanıldı. Tedavi başlangıcında
tiroid stimülan hormon (TSH), serbest T3 (ST3), serbest T4
(ST4) düzeyleri normal, antinükleer antikor (ANA) negatif idi.
Tedavinin altıncı ayında hastanın; TSH 60.52 (↑), FT3 4.06
(N), FT4 4.48 (↓), Tiroglobulin (TG) 1.6 ng/ml (N), antitiroglobulin
antikor (ATA) 631 IU/ml (↑), anti-mikrozomal
antikor (AMA) 1000IU/ml (↑) olarak tespit edildi. Tiroid
ultrasonografisinde; bilateral hipoekoik olan tiroid parenkimi
içerisinde fibröz septalar (psödolobülasyon) ve artmış kanlanma
(Hashimato tiroiditi ?) görüldü. Tiroid sintigrafisinde;
non-homojen hiperplazik tiroid glandı ve sol lobta hiperaktif
nodül tespit edildi. Tiroid biyopsisi; benin sitoloji olarak
değerlendirildi. Hastada interferona bağlı hashimato tiroiditi
düşünülerek IFN tedavisi kesildi ve lamivudin tedavisine
geçildi. Hastaya iyatrojenik hipertiroidi nedeniyle levotiron
1x1 tedavisi başlanıldı. Levotiron tedavisinin 3. ayında TSH
0.190, ST3 5.6, ST4 21.24 olarak saptandı ve levotiron kesildi.
İnterferon tedavisi kesildikten 6 ay sonra yapılan tetkiklerinde
TSH 0.742, ST3 5.33, ST4 14.53 idi. Daha sonraki takiplerinde
tiroid fonksiyonlarında bozukluk tespit edilmedi.
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