Thyroid dysfunction in patients with chronic hepatitis C: Virus‐ or therapy‐related?

Vezali, Elena; Elefsiniotis, Ioannis; Mihas, Constantinos; Konstantinou, Evangelos; Saroglou, George

doi:10.1111/j.1440-1746.2009.05812.x

Cited by 38 publications

(45 citation statements)

References 36 publications

(55 reference statements)

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“…While there is a pharmacologic rationale for interferon's role in hyperthyroidism, the role of ribavirin in inducing such an ADR is still unclear. 9,16,31 Clinical manifestations of thyroid disease induced by interferon may vary in thyroiditis, hypothyroidism, and hyperthyroidism. The medical literature supports the hypothesis of an immunemediated mechanism or direct toxic effects on the thyroid gland.…”

Section: Class and Drugmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Furthermore, given that viral infections are associated with a vaAm J Health-Syst Pharm-Vol 70 Jun 15, 2013 riety of organ system abnormalities (e.g., bone marrow disorders, renal failure, thyroid dysfunction), they put patients at greater risk for developing ADRs. [7][8][9][10][11] One of the major consequences of antiviral-related ADRs is therapeutic failure due to patients' nonadherence to pharmacotherapy. For instance, the premature discontinuation of ribavirin-interferon combination therapy has been estimated to occur in one third of users, 12 who generally discontinue the treatment because of influenzalike symptoms along with neuropsychiatric and hematologic adverse effects.…”

mentioning

confidence: 99%

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Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Pugi

Bonaiuti

Maggini

et al. 2013

American Journal of Health-System Pharmacy

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Section: Class and Drugmentioning

confidence: 99%

mentioning

confidence: 99%

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Pugi

Bonaiuti

Maggini

et al. 2013

American Journal of Health-System Pharmacy

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“…Mixed cryoglobulinaemic vasculitis may also lead to Raynaud's Syndrome [10] and Sicca Syndrome [11] and glomerulonephritis [12] . Many rheumatologic manifestation s associated with HCV infection include arthralgia, myalgia, arthritis, vasculitis, sicca symptoms, mixed cryoglobulinemia (MC) and fibromyalgia and associations have been reported between HCV infection and other autoimmune diseases including systemic lupus erythematosus, Sjogren's syndrome, and antiphospholipid antibody syndrome (APS) [13][14][15][16] . Musculoskeletal pain is the most frequently described complaint among HCV patients, with descriptions of arthralgia, myalgia, fibromyalgia, and arthritis [17] .…”

Section: Original Articlementioning

confidence: 99%

The Significance of Articular Hand Manifestations in Chronic HCV Patients

Bassiony

Dahan

Zaky

et al. 2014

Journal of Gastroenterology and Hepatology Research

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Aim:To evaluate the significance of rheumatic hand manifestations in chronic HCV patients. methods: Two hundred and ninety seven HCV patients were subjected to history taking, clinical examination, laboratory investigations including erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), antinuclear antibody (ANA) and anti-cyclic citrullinated peptide (Anti-CCP) and plain X-ray for hands and wrists. Results: The range of patients' age was 18-82 years (43.97±13.56). Their disease duration ranged from 6 months to 25 years (7.3+5.6).Hand affection was present in 137 patients (46.1%). The most frequent hand manifestations were arthralgia (28.6%), tenosynovitis (10.1%), Raynaud's phenomenon (9.1%), and arthritis (5.1%), while laboratory abnormalities were RF in (38.4%), ANA in (6.4%), cryoglobulins in (9.4%) and Anti-CCP in (1.3%). Female gender was the most important risk factors for hand manifestations. The patterns of arthritis in chronic HCV patients were non deforming polyarticular arthritis that affected the small joints of the hands and oligoarthritis. ConClusion: Our study strongly supports a direct role of HCV in inducing rheumatic hand manifestations and autoantibodies in chronic HCV patients, but it is mostly non-deforming and nonsignificant. Surveillance is needed for the detection of rheumatic manifestations and autoantibodies with occasional multidisciplinary team (hepatologist and rheumatologist) approach to HCV patients for early diagnosis and treatment. A long term follow up study for rheumatological manifestations in HCV patients is recommended to reduce health disparities.

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“…The reported prevalence of HCV and Peg-INF-α induced thyroiditis in developed countries ranges between 2.5% to 35% [23]. Currently there are only two available reports from the Middle East and the prevalence ranged between 8.5 and 20% [24,25].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of thyroid disorders and the correlation of thyroid profile with liver enzymes, serum activin-A and follistatin during the treatment of patients with chronic hepatitis C genotype 1 and 4

Ashshi

El-Shemi²,

Alzanbagi³

et al. 2014

J Clin Exp Invest

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ÖZETAmaç: Kronik hepatit C (KHC) ve Peg-interferon-alfa (Peg-INF-α) serum aktivinleri ve follistatini düzenler ve tiroid hastalıkları (TH) ile birliktedir. Bu çalışmanın amacı KHC'nin indüklediği TH sıklığını belirlemek ve karaciğer hasarı, serum activin-A ve follistatin'in tiroid fonksiyonları ve tiroid otoantikorları ile ilişkisini araştırmaktır.Yöntemler: Bu çalışma kesitsel olup, 3 gruba ayrılan 132 KHC'li hastadan serumları alınmıştır: Tedavisiz 56 hasta, 24 haftalık Peg-INF-α tedavisi almış 30 hasta ve Peg-INF-α tedavisi tamamlanmış 46 hasta. Tiroid stimülan hormon (TSH), serbest tiroksin (FT4) ve tiroid otoantikorları, serum activin-A ve follistatin düzeyleri ELISA yönte-miyle ölçüldü. Bulgular:Hastaların %15'inde (n=20) tiroid hastalığı saptandı, bunların çoğunluğu (%80) otoimmün tiroidit olup, kadınlarda daha sık (%70) idi. TSH reseptör antikorları (TSHR-Abs), diğer antikorlardan anlamlı yüksek bulundu (p<0,05) ve 24 haftalık tedavi grubunda anlamlı artmıştı (p<0,05). TSH ve FT4 karaciğer enzimleri ile anlamlı kö-rele idi (p<0,05). Tiroid hastalığı olanlarla ötiroid olanlar arasında activin-A ve follistatin değerleri bakımından anlamlı fark yoktu (p>0,05). Ancak TSHR-Abs ile follistatin, activin-A ve activi/follistatin oranı arasında anlamlı korelasyonlar saptandı (p<0,05) . Sonuç:Hastalarımızda KHC ve/veya Peg-INF-α'nın indüklediği tiroid bozuklukları yaygın olup, bunların çoğu otoimmundur ve kadınlarda daha sık idi. İlaveten, activin-A ve/veya follistatin TSHR-Abs oluşumu/agrevasyonunda etkili olabilir. Sonuçlarımızı doğrulamak ve KHC'daki tiroid hastalıkları oluşum mekanizmalarını açıklamak için ilave çalışmalara gereksinim vardır.Anahtar kelimeler: Kronik hepatit C, tiroid hastalığı, activin-A, follistatin, Suudi Arabistan ABSTRACTObjectives Chronic hepatitis C (CHC) and peg-interferon-α (Peg-INF-α) modulate serum activins and follistatin and are associated with thyroid disorders (TD).The aim of this study was to determine the frequency of CHC induced TD and to investigate the correlation of liver damage, serum activin-A and follistatin with the thyroid function parameters and thyroid autoantibodies. Methods:The study was cross-sectional and sera were obtained from 132 patients with CHC who were divided into 3 groups: 56 patients with no treatment, 30 after 24 weeks of Peg-INF-α and 46 at the end of 48 weeks Peg-INF-α. Thyroid stimulating hormone (TSH), free thyroxin (FT4), thyroid antibodies (Tabs), serum activin-A and follistatin levels were measured using ELISA.Results: Thyroid disorders were detected in 15% (n=20), more frequent in females (70%) and the majority were autoimmune thyroiditis (80%). TSH receptor antibodies (TSHRAbs) were significantly prevalent compared to the other antibodies (p<0.05) and significantly increased in the 24 weeks group (p<0.05). TSH and FT4 correlated significantly with liver enzymes (p<0.05). There was no significant difference in activin-A and follistatin values between thyroid disorder and euthyroids. However, significant correlations were found between TSHR-Abs ...

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Thyroid dysfunction in patients with chronic hepatitis C: Virus‐ or therapy‐related?

Cited by 38 publications

References 36 publications

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

The Significance of Articular Hand Manifestations in Chronic HCV Patients

Prevalence of thyroid disorders and the correlation of thyroid profile with liver enzymes, serum activin-A and follistatin during the treatment of patients with chronic hepatitis C genotype 1 and 4

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