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Chapter 5 Paul Aoun and David S. Cooper Objectives Interferon-alpha (IFN-) treatment for hepatitis C virus (HCV) and other disorders has been associated with an increased risk for thyroid dysfunction and autoimmu- nity. Here, we report the case of a 50-year-old woman who developed Graves’ dis- ease in the setting of IFN- therapy for HCV. We discuss potential mechanisms of thyroid disease induction, recommendations for screening, and clinical strategies for the management of patients who develop IFN-related thyroid disease. Case Presentation Ms. M.B. is a 50-year old woman with hepatitis C and no history of thyroid disease. She was referred to the endocrine clinic for evaluation of abnormal serum thyroid function tests (TFTs) in the setting of interferon alfa-2b (IFN--2b) therapy for HCV. Three months after starting her treatment, she began experiencing insomnia, weight loss, weakness, palpitations, and shortness of breath. She denied heat intoler- ance, nervousness or tremor, bowel changes, dysphagia, neck discomfort, or visual disturbances. On physical examination, the blood pressure was 120/80 and the pulse was 78 and regular. There was no exophthalmos. The thyroid was not palpable, nontender, and there was no bruit audible her skin was warm and moist. There was no tremor of
Published: Jan 1, 2008
Keywords: Thyroid Dysfunction; Thyroid Autoimmunity; Antithyroid Drug; Thyroid Autoantibody; Subacute Thyroiditis
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