Autoimmune
thyroiditis and delayed onset psoriasis in association with combination therapy
for chronic hepatitis C infection.
Chong VH.
Singapore Med J.
2011 Feb;52(2):e20-2.
A combination of pegylated interferon and ribavarin is currently
the gold standard for the treatment of chronic hepatitis C infection. Interferon
therapy can lead to the development of an autoimmune phenomenon that can be
sub-clinical or clinical, and the presence of autoantibodies increases the risk.
Thyroiditis is the most common autoimmune manifestation of interferon therapy
and can present during treatment or after the completion of treatment. On the
other hand, psoriasis is rare, and has been reported to occur within weeks of
starting the treatment. We report a case of a 46-year-old indigen woman who was
positive for multiple autoantibodies, and developed autoimmune thyroiditis that
manifested as hypothyroidism during pegylated interferon and ribavarin therapy
for chronic hepatitis C infection. She also developed plaque psoriasis after the
completion of therapy. In our case, the association with thyroiditis was
definite, whereas that with psoriasis was less definite. However, it is still
important for clinicians to be aware of such rare associations.
Correspondence:
Chong VH.
Gastroenterology and Hepatology Unit, Raja Isteri Pengiran Anak Saleha Hospital,
Bandar Seri Begawan, BA 1710, Brunei Darussalam.
chongvuih@yahoo.co.uk.
