• Diana Georgiana Lazăr Hipocrat 2000 Medical Clinic, Bucharest, Romania
  • Sabina Elena Oroș Department of Endocrinology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania & 3. Department of Clinical Endocrinology, “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania
  • Florica Sandru Department of Dermatology, ”Carol Davila” University of Medicine and Pharmacy, Bucharest & 5. Department of Dermatovenerology, Elias University Emergency Hospital, Bucharest, Romania
  • Luminița Suveică 6. Family Medicine Department, “Nicolae Testemițanu” State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Moldova
  • Mara Carșote Department of Endocrinology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania & Department of Clinical Endocrinology, “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania
Keywords: Anakinra, pericarditis, thyrotoxicosis, interleukin-1 receptor antagonist, autoimmune thyroid disease


Anakinra, a recombinant, but slightly modified version of the non-glycosylated form of human interleukin-1 receptor antagonist, has been used for various conditions, including the most recent indication, namely, some forms of sever coronavirus infection. Despite a large area of immune and autoimmune interferences and side effects, no specific endocrine issue has been highlighted yet. Here, we report a young female who was prior confirmed with a history of recurrent liquid pericarditis that turned out to be resistant to glucocorticoids and colchicine, thus Anakinra was initiated and showed good clinical results. However, the patient started to experience a mild, but suggestive, clinical picture of thyrotoxicosis which was confirmed by the lab findings. Despite negative thyroid antibodies, the subject did not undergo medication with anti-thyroid medication, only with beta-blockers, and showed a progressive clinical remission within a few weeks. Also, a correction of the thyroid function was observed followed by a spontaneous switch to primary hypothyroidism in addition to a mild elevation of the serum anti-thyroperoxidase antibodies, consistent with the diagnosis of an autoimmune thyroid disease. Whether prior glucocorticoids exposure had a negative impact of the level of antibodies against thyroid or Anakinra was responsible for de novo induction of these mentioned thyroid anomalies is yet to be proven. Moreover, it is still a matter of debate the role played by the positive family history with respect to the same autoimmune thyroid condition that might raise the issue of a selective group of Anakinra candidates that are prone to develop thyroid consequences. Further clinical and pathogenic studies are necessary on this particular novel insight.


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