Thyrotoxicosis with pegylated interferon alfa-2b.

Abstract

BACKGROUND:

Despite adequate surgery, a diagnosis of stage III melanoma carries a high risk of relapse, and hence mortality. Interferon alfa is the only treatment that has currently been shown to alter the natural history of the disease, delaying relapse-free survival, particularly in patients with micrometastatic disease. There is also recent evidence of a prognostic advantage conferred by the development of autoimmune conditions in patients receiving adjuvant interferon therapy.

OBSERVATIONS:

We present the case of a 27-year-old woman with stage IIIa melanoma who was entered into the European Organisation for the Research and Treatment of Cancer 18991 trial of 5-year adjuvant treatment with pegylated interferon (peginterferon) alfa-2b. The patient developed thyrotoxicosis 3 months after commencing treatment, which required treatment with propylthiouracil. The degree of thyrotoxicosis corresponded closely to the dose of peginterferon alfa-2b given. However, in this patient, the hyperthyroidism resolved spontaneously after 4 years when peginterferon treatment was still ongoing. Seven years following the initial diagnosis, the patient has not had disease relapse.

CONCLUSION:

Hyperthyroidism is less common than hypothyroidism as a consequence of interferon therapy, and this case is atypical in that it resolved spontaneously during interferon therapy but is in accordance with the recent evidence of a positive association between interferon-associated autoimmunity and prognosis.

• Authors: Sarah A Lowndes, Ruth Asher, Mark R Middleton
• Journal: Archives of dermatology (Arch Dermatol) Vol. 146 Issue 11 Pg. 1273-5 (Nov 2010) ISSN: 1538-3652 [Electronic] United States
• PMID: 21079065 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• peginterferon alfa-2b

Topics

• Adult
• Female
• Humans
• Interferon alpha-2
• Interferon-alpha (adverse effects)
• Melanoma (drug therapy, pathology)
• Polyethylene Glycols (adverse effects)
• Recombinant Proteins
• Skin Neoplasms (drug therapy, pathology)
• Thyrotoxicosis (chemically induced, drug therapy)