Fatigue occurs in more than 70% of @entity1 treated with interferon-alpha ( @entity3027 ) and is the most problematic @entity137 associated with IFN-based immunotherapy. Abundant evidence suggests that immune-mediated @entity4903 occurs during @entity3027 therapy, which may contribute to the etiology of @entity1295 . @entity1669 is a well-recognized consequence of @entity3027 therapy and may be mediated by the induction of @entity379 production by lymphocytes. Administration of exogenous @entity379 has been associated with upregulation of class II major histocompatibility antigens in the thyroid and the development of @entity1374 . Interferon-alpha also stimulates the production of @entity650 ; both @entity650 and @entity379 have specific effects on thyrocyte function. There also is evidence suggesting that @entity3027 initiates a cytokine cascade that effects the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes, thus affecting regulation of glucocorticoid and sex @entity134 hormone secretion, but the clinical significance of these observations has not been established. Although @entity4903 will not explain the occurrence of @entity5815 in all @entity1 , there is clear evidence that @entity2338 syndromes occur in a relatively large portion of @entity1 receiving systemic @entity3027 therapy. Most importantly, the possibility of @entity1375 must be considered; however, diagnosis of @entity1375 in @entity5 @entity1 is complicated by the occurrence of the "sick @entity3214 ." Clinical recommendations for assessment and treatment of @entity3027 -induced @entity1295 are offered. Most importantly, measurements of thyroid-stimulating hormone and antithyroid autoantibodies should be used to evaluate thyroid status. Acknowledging the limitations of current clinical data, adrenal- and @entity10844 also must be considered in @entity1 with @entity3027 -induced @entity1295 .

Endocrine-mediated mechanisms of XXXX during treatment with interferon-alpha.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity650 :: ('3569', 'Gene') :: ['interleukin-6'] @entity2338 :: ('MESH:D004393', 'Disease') :: ['hormonal deficiency'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity1375 :: ('MESH:D007037', 'Disease') :: ['hypothyroidism'] @entity10844 :: ('MESH:D006058', 'Disease') :: ['gonadal-axis dysfunction'] @entity1669 :: ('MESH:D013967', 'Disease') :: ['Autoimmune thyroid disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1295 :: ('MESH:D005221', 'Disease') :: ['fatigue'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid'] @entity3214 :: ('MESH:D005067', 'Disease') :: ['euthyroid syndrome'] @entity379 :: ('3458', 'Gene') :: ['IFN-gamma'] @entity5815 :: ('MESH:D015673', 'Disease') :: ['fatigue symptoms'] @entity3027 :: ('3439', 'Gene') :: ['IFN-alpha'] @entity4903 :: ('MESH:D004700', 'Disease') :: ['endocrine disease'] @entity1374 :: ('MESH:D013959', 'Disease') :: ['thyroiditis']
@entity1295 :: (MESH:D005221,Disease) :: ['fatigue']
