Graves' disease induced by IFN-β1a therapy: A case report, review of literature and new insights into the pathogenesis

Armando Patrizio; Tommaso Viva; Silvia Martina Ferrari; Giusy Elia; Francesca Ragusa; Sabrina Rosaria Paparo; Alessandro Antonelli; Poupak Fallahi

doi:10.1016/j.autrev.2022.103238

Graves' disease induced by IFN-β1a therapy: A case report, review of literature and new insights into the pathogenesis

Autoimmun Rev. 2023 Feb;22(2):103238. doi: 10.1016/j.autrev.2022.103238. Epub 2022 Nov 24.

Authors

Armando Patrizio¹, Tommaso Viva², Silvia Martina Ferrari³, Giusy Elia⁴, Francesca Ragusa⁴, Sabrina Rosaria Paparo⁴, Alessandro Antonelli⁵, Poupak Fallahi⁶

Affiliations

¹ Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, Italy.
² University of Milan, Milan, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy.
³ Department of Clinical and Experimental Medicine, University of Pisa, Italy.
⁴ Department of Surgical, Medical and Molecular Pathology and of Critical Area, University of Pisa, Italy.
⁵ Department of Surgical, Medical and Molecular Pathology and of Critical Area, University of Pisa, Italy. Electronic address: alessandro.antonelli@unipi.it.
⁶ Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.

PMID: 36436749
DOI: 10.1016/j.autrev.2022.103238

Abstract

Since 1997, when the first case of autoimmune hyperthyroidism induced by Interferon (IFN)-β1b therapy was described, we know about the risk of thyroid dysfunction related to this treatment, particularly in patients with preexisting thyroid autoimmune disorders (AITD). A 60-year-old female, with a 15-year history of euthyroid autoimmune thyroiditis and a 3-year history of Multiple Sclerosis (MS), was admitted to our department for the evaluation of hyperthyroidism. Twenty months before, she had started specific immunomodulant IFN-β1a therapy (30 μg/week). At the first visit, the patient complained tachycardia, weight loss, blurry vision with swollen eyes and excessive lacrimation; thyroid tests showed hyperthyroidism with positive TSH-receptor-autoantibodies. Further evaluation with orbit Magnetic Resonance Imaging (MRI) revealed bilaterally mild enlargement of the extraocular muscles, supporting the suspect of Graves' ophthalmopathy (GO). To our knowledge, this is the first report of Graves' disease (GD) and ophthalmopathy associated with IFN-β1a treatment in a patient with MS. Furthermore, this case could open new interesting knowledge behind GD immunopathogenesis.

Keywords: Graves' disease; Graves' ophthalmopathy; IFN-β; Multiple sclerosis; Th1 chemokines.

Publication types

Review
Case Reports
Letter

MeSH terms

Autoantibodies
Female
Graves Disease* / complications
Graves Disease* / drug therapy
Graves Ophthalmopathy*
Humans
Hyperthyroidism*
Middle Aged
Thyroiditis, Autoimmune*

Substances

Autoantibodies