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Evaluation of Thyroid Functions in Patients with Multiple Sclerosis Before and after Treatment with Interferon Beta

Magda Shokry Mohammed, Nihad Shoukry Shoeib, Inas Mohammed Sabry, Dina Mohammed Abd El Gawad, Ahmed Mohamed Bahaaeldin and Nahla Nader Adly

Background: Multiple sclerosis (MS) is a multi-component disease characterized by inflammation, neurodegeneration and failure of central nervous system (CNS) repair mechanisms. Autoimmune thyroid disease is a frequently studied disorder in MS, most studies have focused primarily on the increased prevalence of thyroid dysfunction and anti-thyroid antibodies (ATAs) in MS patients compared with a control population.

Objectives: To investigate the effect of treatment with interferon beta on thyroid functions and autoimmune thyroid markers in patients with multiple sclerosis.

Subjects and Methods: This prospective study was conducted on 100 subjects recruited from the inpatient and outpatient clinic of Internal Medicine department and Neurology Unit of Ain Shams University Hospitals. They were divided into group 1, which included 50 patients newly diagnosed with multiple sclerosis according to Macdonald’s criteria 2010 and group 2, which included 50, age and sex matched healthy volunteers. All participants were exposed before and 6 months after treatment with interferon beta to Expanded disability status scale (EDSS), which is a method of quantifying disability in multiple sclerosis, Free T4, Free T3 and TSH, Anti thyroid peroxidase (anti- TPO) and anti-thyroglobulin (anti TG) antibodies, MRI brain and neck ultrasonography.

Results: Anti thyroid peroxidase antibody levels were significantly higher in the drug naïve patients group after treatment with interferon beta (29.660 ± 28.755 IU/ml) in comparison to their baseline values (17.580 ± 4.982 IU/ml) (p-value=0.004). Anti-thyroglobulin antibody levels were significantly higher too after treatment with interferon beta (33.920 ± 32.553 IU/ml) in comparison to baseline values (24.560 ± 20.101 IU/ml) (p- value=0.01).

Conclusion: IFN-β therapy has a strong impact on the auto-immune thyroid markers status and levels in drug naïve MS patients causing increase in both anti TPO and anti TG positivity statues and numerical values.