Destructive Thyroiditis Followed by Hypothyroidism Associated with Infliximab Therapy |
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| Institution: | 1. Departments of Endocrinology, Instituto Português de Oncologia de Lisboa;2. Departments of Nuclear Medicine Department, Instituto Português de Oncologia de Lisboa;3. Departments of University Clinic of Endocrinology, Faculdade de Ciências Médicas, Universidade Nova de Lisboa.;1. Departments of Respiratory Medicine;2. Neurology, Kobe City Medical Center General Hospital, Kobe;3. Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan;1. Division of Pediatric Endocrinology and Diabetes, Children’s Hospital of Philadelphia;2. University of Pennsylvania School of Nursing;3. The Craig-Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia;4. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania;5. Institute for Translational Medicine & Therapeutics; Clinical & Translational Research Center, Perelman School of Medicine at the University of Pennsylvania;6. Leonard Davis Institute of Health Economics, University of Pennsylvania.;1. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota;2. Departments of Medicine, University of Minnesota, Minneapolis, Minnesota;3. Departments of Pharmacology, University of Minnesota, Minneapolis, Minnesota;1. Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland;2. Department of Pediatrics, Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland |
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| Abstract: | ObjectiveTo present the rare case of a patient who developed destructive thyroiditis accompanied by transient thyrotoxicosis resulting from infliximab therapy for the treatment of psoriasis.MethodsThe clinical presentation and management of a case with infliximab-associated thyroiditis is described with a brief review of the literature.ResultsA 57-year-old male who suffered from psoriasis was treated with infliximab therapy for 4 years. Thyroid function tests were normal before infliximab therapy. When the patient presented in our clinic, he had thyrotoxicosis and was using propylthiouracil. A 99m Technetiumpertechnetate thyroid scintigraphy scan showed no visualization of either thyroid lobe or decreased thyroid iodine uptake. Thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody (anti-TPO Ab) and thyroglobulin antibody (anti-Tg Ab) were negative. Thyroid ultrasonography revealed a heterogeneous thyroid gland without nodules. After stopping propylthiouracil therapy, we advised monitoring of his thyroid function tests in the following weeks, and infliximab therapy for psoriasis was continued. Four weeks later, his thyroid function tests showed an elevated TSH level with normal levels of free triiodothyronine and thyroxine (FT3 and FT4, respectively), and levothyroxine treatment was administered to the patient. Thyroid function tests normalized after levothyroxine treatment. One year later, infliximab therapy was stopped because of clinical remission. Simultaneously, levothyroxine treatment was also stopped. His thyroid function tests were normal 6 weeks after the cessation of levothyroxine treatment.ConclusionTo our knowledge, the present report is the third infliximab-associated thyroid disorder case. Periodic follow-up of thyroid function tests is necessary during infliximab therapy. (Endocr Pract. 2014;20:e207-e210) |
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