Case report
The influence of hepatitis C infection and interferon-α therapy on thyrotropin blocking and stimulating autoantibodies in Graves' ophthalmopathy: a case report
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* Corresponding author: Huy A Tran huy.tran@hnehealth.nsw.gov.au
1 Department of Clinical Chemistry and University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, New South Wales 2310, Australia
2 Department of Immunopathology and University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, New South Wales 2310, Australia
Thyroid Research 2009, 2:12 doi:10.1186/1756-6614-2-12
Published: 2 December 2009Abstract
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-α, 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.