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. 2009 Dec 2;2(1):12.
doi: 10.1186/1756-6614-2-12.

The influence of hepatitis C infection and interferon-alpha therapy on thyrotropin blocking and stimulating autoantibodies in Graves' ophthalmopathy: a case report

Huy A Tran  1 , Glenn Em Reeves
Affiliations

The influence of hepatitis C infection and interferon-alpha therapy on thyrotropin blocking and stimulating autoantibodies in Graves' ophthalmopathy: a case report

Huy A Tran et al. Thyroid Res. .

Abstract

Background: Hepatitis C virus is a highly immunogenic pathogen often inducing autoimmune activation changes and this can often be further exacerbated by Interferon therapy. As HCV is lymphocytotropic, it can modulate T cell and B cell antibody responses, affecting many endocrine organs, most commonly the thyroid.

Case presentation: We hereby describe a case of fluctuating and wavering thyrotropin autoantibodies of both stimulating and blocking nature in the setting of Graves's ophthalmopathy, hepatitis C infection and interferon-alpha, causing hypo- and subsequently hyper-thyroidism. The autoantibody profile was clearly modified during interferon therapy and settled into a new equilibrium at the completion of treatment.

Conclusion: The case highlights the possible existence of a dual thyroid autoantibody population associated with hepatitis C, and its modulation by interferon therapy, which further compounds the difficulties in the assessment thyroid disease in this setting.

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Figures

Figure 1
Figure 1
Magnetic Resonance Imaging of the orbits, showing congestion of the retro-orbital space and enlargement of the extraocular muscles (arrows), consistent with the diagnosis of Graves' Ophthalmopathy.
Figure 2
Figure 2
The immunomodulating effect of Interferon therapy on the TS and TB subsets of autoantibodies and its effects on thyroxine dosage and nuclear uptake patterns. Note: the graphs are only approximate representations, not to exact scale.
See this image and copyright information in PMC

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