THYROID DYSFUNCTIONS IN THE PATIENTS WITH CHRONIC ACTIVE HEPATITISWITH HVC PREVIOUSLY AND AFTER THE TREATMENT WITH PEGINTERFERON α 2A 180 μg
Abstract:
treatment with Peginterferon α2A, 180 μg / week and Ribavirină in dose adaptated to the
weight, with the aim of establishing the frecquency of apparition of the thyroid dysfunction in the context
of the specific treatment.Concomitantly,it has been pursued the establishing of correlations between age,
sex, degree of activity of the disease, the possible moment of the infection and the apparition of the
clinical and paraclinical thyroid modifications. Methodes: The prospective clinical study was realised
on a lote of 115 patients with chronic active hepatitis with HVC, aged between 18 – 65 years. The
patients were taken from the clinic and ambulatory of the Clinical Emergency Hospital of Sibiu, during
2005 – 2010. The criteria of inclusion and exclusion were the ones imposed by the CNAS protocol: age
between 18 – 65 years, the increased level of the transaminases normal or increased, detectable viremy,
hepatic biopsy punction. Results: I have remarked since the beggining the increased incidence
(statistically meaningful) before the beggining of the therapy with antithyroid antibodies in the studied
lote in comparison with the population without viral hepatic pathology. Thus, 11 patients presented at
the beggining of the treatment antithyroid antibodies, representing 9,6 %. Among them, 8 were females
and 3 were males. Ulterior, during treatment, the number of patients that had antithyroid antibodies
increased progressively, being of 18 patients at 3 months, respectively 21 patients at the end of the
treatment. It has been observed that the majority of the patients that developed chronic autoimmune
thyroiditis at the end of the treatment had antithyroid antibodies in the first three months. Also, it has
been observed a predominance of the cases at the females (14 among 18). The last determination of the
antithyroid antibodies was effectuated at the end of the therapy. The monitorisation after treatment is
curently developing, so we can not appreciate the extension during the time of the chronic autoimmune
thyroiditis. Concomitantly, the evaluation of the TSH, T3 şi T4 at the beggining of the treatment
evidentiated the existence of a number of 2 patients with hypothyroidism and the absence of
hyperthyroidism. Both patients with hypothyroidism were females. During treatment the number of
patients with hypothyroidism increased, as in the end of the therapy the cases were 9, among them 6
women and 3 men. Again, it has been remarked the prevalence of the females. The majority of the cases
had medium and simple hypothyroidism. There was a case, a female aged 48 years, a patient that
presented antithyroid antibodies at the beggining of the treatment, also a simple hypothyroidism, whose
evolution under the treatment with Peginterferon α2A was to mixedem coma, the patient neccesitating
specialty treatment in an intensive therapy unit. Conclusions: The thyroidian events manifestated on the
whole had an incidence of 9,5% in our study (tiroiditis, hypo – and hyperthyroidism), situating our
study at least in percentage in the limits of the studies developed at an European level.
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