Severe Pericardial Effusion due to autoimmune Hypothyroidism with Levothyroxine withdrawal and systemic Lupus Erythematosus / Journal of the ASEAN Federation of Endocrine Societies

@#The presence of autoantibodies is a common link between autoimmune hypothyroidism (AH) and Systemic Lupus Erythematosus (SLE). The coexistence of AH (Hashimoto’s Thyroiditis) and SLE is common; however, massive pericardial effusion (PEEF) with signs of tamponade is extremely rare and only a few cases have been reported in literature. We present a case of a 54-year-old female who came in with progressive dyspnea who was found out to have massive PEEF from overt AH and concurrent SLE, which was successfully managed medically. This gave us valuable insight that massive pericardial effusion occurring in overt hypothyroidism may be secondarily caused by other co-existing disease entities such as SLE. The importance of the correct diagnosis cannot be overemphasized, as this largely contributed to the successful management of this case.

Interferon-Alpha Induced Severe Hypothyroidism Followed by Graves' Disease in a Patient Infected with Hepatitis C Virus

Interferon-alpha (IFN-alpha) is an important therapeutic agent for hepatitis C virus (HCV) infection, but has various side effects including thyroiditis. We report a case of interferon-induced non-autoimmune hypothyroidism followed by autoimmune-medicated Graves' disease. A 59-year-old woman was diagnosed with chronic active hepatitis C; she had been treated with IFN-alpha and ribavirin for 24 weeks. Before starting the IFN-alpha, her thyroid function was normal and she was negative for autoantibodies. Severe hypothyroidism developed 5 weeks after halting the IFN-alpha, with the Graves' disease phase arising at 32 weeks. For accurate diagnosis and appropriate treatment of thyroid dysfunction during treatment with IFN-alpha, we need to understand and consider rare cases of multiphasic disorder involving both non-autoimmune and autoimmune thyroiditis induced by IFN-alpha.

Tireoidite autoimune na criança e no adolescente / Autoimmune thyroiditis in children and adolescents

Objetivo: Revisão da literatura sobre a tireoidite de Hashimoto no universo das doenças autoimunes em crianças e adolescentes. Fontes: MEDLINE, utilizando os termos tireoidite, doença de Hashimoto, genética da autoimunidade tireoidiana. Resumo: Doenças tireoidianas autoimunes são doenças endócrinas frequentes da criança e do adolescente. Genes como antígeno humano leucocitário (HLA), antígeno-4 associado ao linfócito T citotóxico (CTLA-4), a proteína tirosina-fosfatase 22 (PTPN22) e os genes específicos da glândula tireoide, como o receptor do TSH (TSHR) e tireoglobulina (Tg) afetam a resposta imunológica da tireoide. A tireoidite autoimune pode apresentar funções tireoidianas desde eutireoidismo até hipotireoidismo evidente, além de um quadro inicial, transitório, de hipertireoidismo e tem sido associada a doenças autoimunes como diabetes, doenças reumáticas, doença celíaca. Função tiroidiana e associações com outras doenças autoimunes são destacados...