NATURAL COURSE OF DYSTHYROIDISM IN PATIEN TS TREATED WITH INTERFERON FOR CHRONIC HEPATITIS-C

Thyroid dysfunction developed in 35 patients among a series of 300 (19 0 men and 110 women) treated with alpha-interferon (35/300 = 12 %. No relationship was observed between the type of alpha-interferon, the do se, or hepatic response, but there were more women (24/35). Anti-thyro id antibody levels were frequently elevated before treatment (8/35, 23 %). Hypothyroidsm developed in 27 patients, 7 with clinical hypothyro idism, 10 with moderate hypothyroidism and 5 with elevated TSH only. P atients with severe symptoms and highly elevated thyroid antibodies we re more prone to develop sustained or iri eversible hypothyroidism (10 patients). Twelve patients recovered a normal thyroid function within a Sew months, brit antibody levels fell more slowly. Primary hyperthy roidism of variable severity appeared in 13 patients. In 8 patients, n ormal thyroid function was recovered within a Sew weeks but thyroid an tibodies remained high Sor at least one year. In 5 others spontaneous hypothyroidism occur-red within a few weeks (<< biphasic >> hypothyroi dism). Direct toxicity appears to be less probable than an autoimmune mechanism; elevated antithyroid antibodies were observed in only 20 pa tients (57 %). In clinical practice, TSH levels should be regularly mo nitored during and after alpha-interferon therapy.