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Patients with multiple sclerosis who are treated with interferon-β may have autoimmune thyroid disease and thyroid dysfunction
The background of the study. Many patients with
multiple sclerosis are treated with interferon-β , an immunomodulatory
molecule that may activate autoimmune thyroid disease. In this study,
thyroid function and autoimmunity were periodically determined in
patients treated for as long as 84 months.
How the study was done. The study subjects were 106 patients with multiple sclerosis. None had received any therapy for at least one month before interferon was started. Serum thyrotropin (TSH), free thyroxine (T4), and antithyroid peroxidase (TPO), antithyroglobulin (Tg), and TSH-receptor antibodies were measured at base line, every three months for one year, and every six months thereafter.
The results of the study. Among the patients with normal thyroid function at base line, 25 (24 percent) had thyroid dysfunction (hypothyroidism, 20 patients; hyperthyroidism, 5 patients) during a follow-up period ranging from 12 to 84 months. The hypothyroidism was permanent in 11 of the 20 patients (55 percent). There were no cases of permanent hyperthyroidism. The risk of thyroid dysfunction was highest during the first year of interferon therapy.
At base line, 9 patients (8 percent) had a high serum antithyroid antibody concentration, of whom 7 had thyroid dysfunction later. Among the 97 patients who had normal values, 22 (23 percent) had high values during follow-up. Among these 22 patients, 12 (54 percent) remained euthyroid and 10 (45 percent) later had thyroid dysfunction.
The conclusions of the study. Both thyroid dysfunction and thyroid autoimmune disease occur in patients with multiple sclerosis who are treated with interferon-β , usually during the first year of therapy.
The original article. Caraccio N, Dardano A, Manfredonia
F, Manca L, Pasquali L, Iudice A, Murri L, Ferrannini E, Monzani
F. Long-term follow-up of 106 multiple sclerosis patients undergoing
interferon-β 1a or 1b therapy: predictive factors of thyroid disease
development and duration. J Clin Endocrinol Metab 2005;90:4133-7.
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| Thyroid Digest Index | | | November 2005 Thyroid Digest |
