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Endocrine Abstracts (2017) 49 EP1209 | DOI: 10.1530/endoabs.49.EP1209

ECE2017 Eposter Presentations: Thyroid Clinical case reports - Thyroid/Others (30 abstracts)

Autoimmune thyroid disease occurring as a possible late complication after a non-occupational HIV Postexposure Prophylaxis

Iulia Crumpei 1, , Voichita Mogos 1, , Maria-Christina Ungureanu 1, , Anamaria Bursuc 1, , Ioana Armasu 1, , Mirela Tirnoveanu 1, , Valentina Adomnicai 2 , Georgiana Constantinescu 1, & Carmen Vulpoi 1,

1University of Medicine and Pharmacy, Iasi, Romania; 2Department of Endocrinology, Iasi, Romania.

Introduction: Nonoccupational postexposure prophylaxis (nPEP) is a three-drug antiretroviral regimen used to decrease the risk for HIV infection after less than 72 h from nonoccupational exposure to body fluids that might contain HIV. The most frequent side effects concern the gastro-intestinal intolerance, renal and hepatic toxicity, with no hormonal imbalance to have been yet reported.

Case report: 24 years old male patient, consulted for palpitations, hoarseness, shortness of breath, laryngeal tightness, weight loss (4 kg /3 months), fatigue, insomnia, recurrent panic attacks and anxiety-symptoms progressively installed since 3 months. Patient’s previous history contains a nonoccupational exposure to body fluids containing HIV 8 months previously, treated with nPEP (Lamivudine, Zidovudine and Kaletra- Lopinavir/Ritonavir), with a negative serology at the check-ups. He presented high blood pressure and tachycardia, tremor, hyperhidrosis and excessive preoccupation concerning his illness. Thyroid tests found an autoimmune thyroiditis with subclinical thyrotoxicosis: ATPO=57.5 IU/ml (N: 0–35), TSH=0.09 μIU/ml (N: 0.4–4), FT4=1.35 ng/ml (N: 0.89–1.76), TRAb- negative, normal thyroid at the ultrasound. Cardiac evaluation was normal so the patient was advised to start betablocker and anxiolitic treatment, along with psychological counselling. At the one month follow-up, the blood test has shown persistence of the thyroid autoimmunity with normalisation of the function: TSH=0.602 μIU/ml, FT4=1.38 ng/dl, without any other abnormalities.

Conclusions: The occurrence of the autoimmune thyroid disease after a 6 month period post nPEP has not yet been cited. It may be a result of either the autoimmune system rebound after the antiretroviral therapy or an inflammatory imbalance induced by the treatment with consecutive immune reconstitution syndrome.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

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