, Volume 13, Issue 1, pp 16–23 | Cite as

Thyroid involvement in hepatitis C — Associated mixed cryoglobulinemia

  • Poupak Fallahi
  • Silvia Martina Ferrari
  • Dilia Giuggioli
  • Andreina Manfredi
  • Caterina Mancusi
  • Silvia Fabiani
  • Marco Centanni
  • Santino Marchi
  • Clodoveo Ferri
  • Alessandro Antonelli



The prevalence and clinical features of thyroid involvement in patients with hepatitis C virus-associated mixed cryoglobulinemia (MC + HCV) have been reviewed.


A PubMed Medline search was conducted through December 2011 to identify all studies that reported thyroid involvement in MC + HCV patients. Reference lists of the papers initially detected were manually searched to identify additional relevant reports. Studies had to contain sufficient and clear information to be included.


In MC+HCV patients, the following thyroid autoimmune abnormalities were significantly more frequent than in controls: high levels of serum anti-thyroperoxidase autoantibody (AbTPO); high levels of serum AbTPO and/or anti-thyroglobulin autoantibody; humoral and ultrasonographical signs of thyroid autoimmunity (35% vs 16%); prevalence of subclinical hypothyroidism (11% vs 2%). Also, the prevalence of papillary thyroid cancer has been found higher in MC + HCV patients than in controls, in particular in patients with autoimmune thyroiditis. The involvement of T helper 1 immunity and chemokine (C-X-C motif) ligand 10 (CXCL10) may be the pathogenetic basis of the association between MC + HCV and thyroid autoimmunity.


These results show a high prevalence of thyroid disorders in patients with MC + HCV and point to the need for careful monitoring of thyroid function in these patients.

Key words

Autoimmunity Chemokines Cryoglobulinemia Hepatitis C Hypothyroidism Thyroid neoplasms 


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Copyright information

© Hellenic Endocrine Society 2014

Authors and Affiliations

  • Poupak Fallahi
    • 1
  • Silvia Martina Ferrari
    • 1
  • Dilia Giuggioli
    • 2
  • Andreina Manfredi
    • 2
  • Caterina Mancusi
    • 1
  • Silvia Fabiani
    • 1
  • Marco Centanni
    • 3
  • Santino Marchi
    • 4
  • Clodoveo Ferri
    • 2
  • Alessandro Antonelli
    • 1
  1. 1.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
  2. 2.Department of Medical, Surgical, Maternal, Pediatric and Adult SciencesUniversity of Modena and Reggio EmiliaModenaItaly
  3. 3.Department of Medico-Surgical Sciences and Biotechnologies“Sapienza” University of RomeLatinaItaly
  4. 4.Department of Translational Research and of New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly

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