Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 14 P373

ECE2007 Poster Presentations (1) (659 abstracts)

Aetiology and therapeutic guideines in thyrid dysfunction at the patients with chronic hepatitis C treated with pegylated interferon and ribavirin

Cristina Cijevschi 1 , Catalina Mihai 1 , Eusebie Zbranca 2 , Andreea Brumaru 1 & Paul Gogalniceanu 1

1Institute of Gastroenterology and Hepatology, Iasi, Romania; &br;2Endocrinological Clinic, University Hospital‘St.Spiridon’, Iasi, Romania.

Introduction: Chronic Hepatitis C is highly prevalent in our country.

Management involves combination treatment with pegylated interferon and ribavirin. Thyroid disease in affected patients can be caused by the hepatitis C virus or by the interferon therapy.

Aims and method: The study aims to investigate thyroid dysfunction and optimal management strategies for patients with chronic hepatitis C treated with pegylated interferon and ribavirin. A prospective study of 68 patients with chronic hepatitis C was undertaken. Patients commenced treatment between1st January 2003 – 1st January 2005. Patients with previous thyroid pathology were excluded from the study. All patients were followed up at 3, 6, 8 and 12 months from starting therapy. Patients were investigated using thyroid echography, TSH, fT3 and fT4 measurement, as well as anti-thyroid anti-body (anti-thyroglobulin and anti-peroxidase) and anti-TSH receptor antibodies assessment.

Results: 11 patients (16.17%) developed thyroid pathology: 7 patients developed hypothyroidism and 4 developed hyperthyroidism. Of the latter, 3 developed destructive thyrotoxicosis and one developed Graves’ disease.6 patients (54.54%) were asymptomatic (especially those with hypothyroidsim), whilst 75% of those with hyperthyroidism were symptomatic. 3 out of 7 patients with hypothyroidism developed antithyroid antibodies, probably due to an undiagnosed destructive thyroiditis. Only 2 patients (18.18% of those with thyroid pathology and 2.94% of all patients) stoped peginterferon treatment due to the thyroid related side effects.

Conclusion: The prevalence of thyroid dysfunction in chronic hepatitis C treated with pegylated interferon and ribavirin is 16.17%, mostly manifesting as hypothyroidism. The majority of patients are asymptomatic. Few patients required cessation of antiviral treatment. Monitoring of thyroid function during antiviral therapy is compulsory.

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