DEVELOPMENT OF AUTOIMMUNE THYROID-DISEASES DURING LONG-TERM TREATMENTOF HEMATOLOGICAL MALIGNANCIES WITH ALPHA-INTERFERONS

In recent years recombinant alpha-interferons (alpha-IFNs) have been w idely used in the treatment of several hematological malignancies. Pro longed courses of IFN have been shown to induce autoantibodies and to support the exacerbation or even the development of autoimmune disease s. In this report we descibe the development of symptomatic autoimmune thyroid diseases in 4 (7.4%) out of 54 patients in chronic treatment with recombinant alpha-IFNs in our department. Two patients developed a disease resembling Hashimoto's thyroiditis after 17 and 49 months of continuous IFN treatment, while the other two developed a typical Gra ves' disease after 41 and 52 months of therapy. The mechanism by which IFN induces autoimmune thyroid diseases, the choice of searching for anti-thyroid autoantibodies before starting long-term IFN treatment, t he option of discontinuing IFN therapy in the presence of overt thyroi d diseases, and the management of these diseases are discussed.