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Interferon-α and Autoimmune Thyroid Disease
Abstract
Interferon-alpha (IFN alpha) is the main therapeutic agent in patients infected with the hepatitis C virus (HCV). It is rather safe, but is known to induce the production of autoantibodies and can lead to the occurrence of autoimmune disease. This minireview focuses on the induction of autoimmune thyroid disease (AITD) in HCV-infected patients treated with IFN alpha. Females carry a higher risk to develop AITD upon IFN alpha treatment, with a relative risk of 4.4 (95% confidence interval 3.2-5.9). The presence of thyroid peroxidase antibodies before therapy has a relative risk for AITD of 3.9 (95% confidence interval 1.9-8.1). IFN alpha-associated AITD can consist of autoimmune primary hypothyroidism, Graves' hyperthyroidism, and destructive thyroiditis, with hypothyroidism being the most common side effect. The clear association between AITD and IFN alpha use suggests that high endogenous IFN alpha levels may also be associated with naturally occurring AITD. High endogenous IFN alpha levels are seen in patients infected with certain viruses. It is concluded that IFN alpha is one of the environmental factors capable of triggering the onset of AITD in genetically susceptible individuals.
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“In a review of published cases from eight series, 69% of 49 patients with IFN-a-associated thyrotoxicosis for whom an etiology was identified were found to have GD, based on either positive TRAb titers or requirement for a prolonged course of ATDs ( 640).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [640]
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Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938
“In a review of published cases from eight series, 69% of 49 patients with IFN-a–associated thyrotoxicosis for whom an etiology was identified were found to have GD, based on either positive TRAb titers or requirement for a prolonged course of ATDs (640).”
BackgroundSelf-citationBahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098
Self-citationThe American Thyroid Association and American Association of Clinical Endocrinologists Taskforce on Hyperthyroidism and Other Causes of Thyrotoxicosis, Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., et al. (2011) · Thyroid · doi:10.1089/thy.2010.0417 · Cited by 898
Self-citationCross-regulation of TNF and IFN-α in autoimmune diseases
Palucka, K., Blanck, J.-P., Bennett, L. B., Pascual, V., & Banchereau, J. (2005) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0408506102 · Cited by 518
The environment and autoimmune thyroid diseases
Prummel, M. F., Strieder, T. G. A., & Wiersinga, W. M. (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.1500605 · Cited by 298
Self-citation
Metadata
- Authors
- Prummel, M. F., & Laurberg, P.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Aalborg University Hospital (DK)
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2003-06
- Volume
- 13
- Issue
- 6
- Pages
- 547-551
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W1805116264
- Cited by
- 221
- References
- 28
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 5 · 2018: 8 · 2017: 6 · 2016: 10 · 2015: 6 · 2014: 8 · 2013: 5 · 2012: 18
- FWCI
- 8.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Keywords
- interferon-alpha, autoimmune thyroid disease, hepatitis C virus, drug-induced autoimmunity, thyroid peroxidase antibodies, primary hypothyroidism, Graves' disease, destructive thyroiditis, sex differences, genetic susceptibility
- MeSH terms
- Autoantibodies, Autoimmune Diseases, Hepatitis C, Humans, Risk Factors, Sex Factors, Thyroid Diseases, Viruses, Incidence, Interferon-alpha
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