An autoimmune aetiology for hypothyroidism following interferon therapy for breast cancer

Fentiman, Ian S.; Balkwill, Frances R.; Thomas, B.S.; Russell, M. J.; Todd, Ian; Bottazzo, Gian Franco

doi:10.1016/0277-5379(88)90219-2

Cited by 111 publications

(35 citation statements)

References 12 publications

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“…Functional NK and LAK activity of PNMCs and the number of PMNCs with NK markers were determined at baseline and after stimulation at day 8 of the third and three of 13 (23%) patients treated for breast cancer (Fentimann et al, 1988). The thyroid dysfunction observed in our study is caused by an autoimmune thyroiditis, as evidenced by the evolution of thyroid function studies, the cellular infiltrates in fine-needle aspirates and by the expression of HLA class II antigens by thyroid epithelial cells.…”

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confidence: 72%

Thyroiditis after treatment with interleukin-2 and interferon α-2a

Pichert

Jost²,

Zöbeli³

et al. 1990

Br J Cancer

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Summary Serial thyroid functions studies were carried out in patients with melanoma and renal cell carcinoma treated with interleukin-2 (3 MU m-2 by continuous infusion days 1-4) and interferon a-2a (6 MU m-2 subcutaneously on days 1 and 4), both given on alternate weeks. The results on eight patients who completed at least three cycles of treatment are described. Four patients developed thyroid dysfunction with a hyperthyroid phase of 2 weeks followed by a hypothyroid phase ranging from 12 to 24 weeks. Two patients became clinically symptomatic and required treatment. Fine-needle aspirates of the thyroid were obtained in three patients with thyroid dysfunction. The considered to be 0-350 IE ml-' with 350-500 U ml-' borderline and > 500 IE ml-X elevated. Levels of anti-nuclear, anti-mitochondrial, anti-parietal and anti-islet cell antibodies were measured by indirect immunofluorescence (Kit from Zeus Scientifics Inc., Raritan, NJ, USA, and DMD AG, Schaffhausen, Switzerland).Cytological studies Fine-needle aspirations were done in three patients with thyroid dysfunction using a 25-gauge needle and a 20 ml disposable syringe in a Cameco-holder. The

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confidence: 72%

Thyroiditis after treatment with interleukin-2 and interferon α-2a

Pichert

Jost²,

Zöbeli³

et al. 1990

Br J Cancer

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“…IFN is useful in the treatment of both certain malignancies and chronic viral hepatitis [1,11], but IFN therapy may lead to autoimmune disease, including thyroid dysfunction [1][2][3][4][5]. The exact mechanism by which IFN-a or -f3 causes thyroid dysfunction is not known.…”

Section: Discussionmentioning

confidence: 99%

“…WITH THE wide use of interf erons alpha (IFN-a) and beta (IFN-f) for the treatment of chronic viral hepatitis and various malignant disorders, it is generally recognized that IFN therapy can induce thyroid dysfunction, either hypothyroidism or hyperthyroidism, by autoimmune mechanisms [1][2][3][4][5]. Although most patients who have developed thyroid dysfunction after IFN therapy have had preexisting autoimmune thyroid diseases, IFN therapy, especially IFN-a, also induced thyroid dysfunction in some patients without preexisting thyroid abnormalities [3,[6][7][8].…”

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confidence: 99%

Effect of Interferon-Beta on Thyroid Function in Patients of Chronic Hepatitis C without Preexisting Autoimmune Thyroid Disease.

et al. 1996

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Abstract. The effect of interferon-beta (IFN-fl) on thyroid function was studied in patients with chronic hepatitis who had no preexisting thyroid disease. Eleven patients (9 males and 2 females) aged 20 to 65 years, with a mean age of 47.7 ± 13.5 years, were treated with 6 million units of IFN-fl intravenously every day for 8 weeks. During IFN-13 administration (4th to 8th week of treatment), both serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations decreased significantly (P<0.0005 and P<0.05, respectively): FT4, 1.37 ± 0.17 to 1.09 ± 0.12 ng/dl, and FT3, 3.71 ± 0.45 to 3.28 ± 0.34 pg/ml. On the other hand, serum TSH increased significantly from a baseline of 1.70 ± 0.82 to 3.34 ± 1.98 jiU/ml during IFN-13 administration (P<0.005). Four to eight weeks after cessation of treatment, the mean serum FT4 concentration was similar to that during IFN-f administration (1.04 ± 0.14 ng/dl), but mean serum FT3 and TSH concentrations returned to pre-treatment levels (FT3, 3.57 ± 0.42 pg/ml and TSH, 1.60 ± 0.84 ,uU/ml). Both reverse T3 and thyroglobulin were essentially unchanged. Tests for anti-thyroglobulin and anti-microsomal antibodies were negative in all the patients. These results indicate that IFN-f3 may inhibit thyroid function in patients without preexisting thyroid disease irrespective of humoral immune responses.

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“…Recently, the development of autoantibodies during and after interferon therapy [1] has been reported. Special attention was drawn to the autoantibodies to the thyroid gland as well as thyroid dysfunction that appeared in some IFN-treated Received: December 2, 1992 Accepted: March 10, 1993 Correspondence to: Dr. Shigeo KATABAMI, Department of Internal Medicine, Muroran City General Hospital, Tokiwacho 2-11, Muroran 051, Japan patients [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. In the present paper, we describe a 51-year-old woman who developed silent thyroiditis at 16 weeks after initiation of IFN treatment for chronic type C hepatitis.…”

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confidence: 99%

“…After recovery of thyroid function, papillary adenocarcinoma was surgically removed on September 25th, 1992. Since hypothyroidism induced by IFN treatment for breast cancer was first reported in 1985 [2], there have been 47 cases in which thyroid dysfunction developed including 8 cases of Graves' disease, 13 of transient thyrotoxicosis and 26 of hypothyroidism during and after IFN therapy (Table 2) [2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”

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confidence: 99%

An Episode of Silent Thyroiditis in a Patient with Chronic Thyroiditis and Papillary Adenocarcinoma Following Alpha Interferon Treatment for Hepatitis C.

et al. 1993

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Abstract.In the present paper we described the first case report of silent thyroiditis following alpha-interferon (IFN-a) treatment for chronic type C hepatitis in Japan. A 51-year-old woman with chronic type C hepatitis was treated with 6 million units of IFN-a three times a week for 24 weeks. Thyroid function was within normal limits and thyroid autoantibodies were negative before IFN therapy. Sixteen weeks after initiation of the treatment, she complained of increasing fatigue, palpitation and losing 7 kg in weight. Thyroid function tests at that time revealed an increase in serum T3, T4, free T3 and free T4 and a markedly suppressed TSH concentration. Both antithyroglobulin antibody (TgAb) and antimicrosomal antibody (McAb) were positive in a dilution of 1: 400. The computed tomographic (CT) scan of the thyroid showed a decrease in the CT number (Hounsfield unit; H.U.) to 58 H.U. (normal, 95-167 H.U.). The 24-h thyroid uptake of 123 I was 0.75%. Aspiration biopsy specimens from a nodule in the right lobe and the remaining struma disclosed papillary adenocarcinoma and Hashimoto thyroiditis, respectively. Thyroid function spontaneously returned to normal two months after the onset of thyrotoxicosis through the subclinical hypothyroid stage. After recovery of thyroid function, patient had an operation of papillary cancer without any complications. These clinical features and laboratory findings led to the diagnosis of silent thyroiditis developing in the course of the long-term IFN therapy, which, to our knowledge, has not been reported before in Japan.

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An autoimmune aetiology for hypothyroidism following interferon therapy for breast cancer

Cited by 111 publications

References 12 publications

Thyroiditis after treatment with interleukin-2 and interferon α-2a

Thyroiditis after treatment with interleukin-2 and interferon α-2a

Effect of Interferon-Beta on Thyroid Function in Patients of Chronic Hepatitis C without Preexisting Autoimmune Thyroid Disease.

An Episode of Silent Thyroiditis in a Patient with Chronic Thyroiditis and Papillary Adenocarcinoma Following Alpha Interferon Treatment for Hepatitis C.

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