ab2005

Thyroid cancer in HCV-related mixed cryoglobulinemia patients

A. Antonelli¹, C. Ferri², P. Fallahi¹, C. Nesti¹, A.L. Zignego³, M. Maccheroni⁴

Department of Internal Medicine¹, Rheumatology Unit², University of Pisa, Pisa; Department of Internal Medicine³, University of Florence, Florence; Endocrinological Laboratory, Azienda Ospedaliera Pisana4, Pisa, Italy.

ABSTRACT
Objective
The prevalence of thyroid cancer in a series of unselected HCV-related mixed cryoglobulinemic patients was investigated in comparison with a control group.

Methods
Among 107 consecutive pa-tients with mixed cryoglobulinemia (MC), 94 were eligible for the study. A control group was obtained from a sample of the general population (2,401 subjects), age > 50 years, who had undergone thyroid ultrasonography (582 subjects); 5 sex-matched controls were randomly assigned to each MC patient (470 individuals). The mean age was similar in the MC patients and controls (64.2 ± 10.0 vs. 63.4 ± 7.0).

Results
The prevalence of thyroid nodules was higher, although not significantly so, in control subjects than in MC patients (65.3 vs. 54.8%). Two patients with papillary thyroid cancer were found in the MC series, while no case was observed among controls (p = 0.001, chi-square P value; p = 0.02, Fisher's exact test). In both MC patients with papillary thyroid cancer lymphocytic infiltration was observed in the thyroid tissue.

Conclusions
The possible association between HCV-related MC and thyroid cancer indicates that a careful monitoring of the thyroid would be opportune during the clinical follow-up of HCV-associated MC patients, especially in those with signs of thyroid autoimmune disorders.

Key words
Mixed cryoglobulinemia, hepatitis C virus, thyroid cancer, thyroid autoimmunity.

Please address correspondence and reprint requests to: Dr. Alessandro Antonelli, Dipartimento Medicina Interna, Universitá di Pisa, Via Roma 67, 56126 Pisa, Italy.
E-mail: a.antonelli@med.unipi.it