The Effect of Hydroxychloroquine Treatment in Hashimoto's Thyroiditis
The Effect of Hydroxychloroquine Treatment in Hashimoto's Thyroiditis
Hashimoto's thyroiditis is an autoimmune thyroid disease, which induced chronic inflammation
 of thyroid gland and destroys thyroid tissue.

 Hydroxychloroquine is used as disease modifying anti-rheumatic drug (DMARD) for treatment of
 several autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid
 arthritis(RA) for more than one century.

 The purpose of this study is to evaluate whether hydroxychloroquine is effective in treatment
 of Hashimoto's thyroiditis.
Hashimoto's thyroiditis is an autoimmune thyroid disease, and when the disease progresses,
 thyroid function finally declined to hypothyroidism.

 There was no medical treatment recommended for patients with Hashimoto's thyroiditis, but
 currently at euthyroid state. Levothyroxine replacement therapy starts if patients become
 hypothyroid state.

 Hashimoto's thyroiditis is a T-cell mediated autoimmune thyroid disease. The major
 auto-antigens include thyroid peroxidase (TPO) and thyroglobulin. Anti-TPO antibodies induce
 antibody-dependent cell-mediated cytotoxicity (ADCC) and cause destruction of thyroid
 tissues.

 Antimalarial agents like hydroxychloroquine have several pharmacologic effects which may be
 involved in the treatment of rheumatic diseases, but the role of each is not known. These
 include interaction with sulphydryl groups, interference with enzyme activity (including
 phospholipase, nicotinamide adenine dinucleotide hydrogen-cytochrome C reductase,
 cholinesterase, proteases and hydrolases), DNA binding, stabilisation of lysosome membranes,
 inhibition of prostaglandin formation, inhibition of polymorphonuclear cell chemotaxis and
 phagocytosis.

 This study is to investigate the treatment effect of hydroxychloroquine on autoantibodies and
 disease progression of Hashimoto's thyroiditis.
Inclusion Criteria:

 -  Hashimoto's thyroiditis

 -  Euthyroid state (free T4 and thyroid-stimulating hormone level within normal limit)

 -  Never receive immunomodulators or immunosuppressants

 Exclusion Criteria:

 -  Planned pregnant or already pregnant women

 -  Renal insufficiency

 -  Hepatic insufficiency

 -  Anemia

 -  Agranulocytosis

 -  Thrombocytopenia

 -  Glucose-6-phosphate dehydrogenase deficiency

 -  Porphyria cutaneous tarda

 -  Allergy to 4-aminoquinolone