Nivolumab Induced Thyroid Dysfunction: Unusual Clinical Presentation and Challenging Diagnosis.

Autor: Iadarola C; Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Croce L; Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy.; University of Pavia, Dottorato in Medicina Sperimentale, Pavia, Italy., Quaquarini E; University of Pavia, Dottorato in Medicina Sperimentale, Pavia, Italy.; Unit of Medical Oncology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Teragni C; Unit of Medical Oncology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Pinto S; Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Bernardo A; Unit of Medical Oncology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Fonte R; Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Marinò M; Endocrinology Unit I, Department of Clinical and Experimental Medicine, University Hospital of Pisa, University of Pisa, Pisa, Italy., Rotondi M; Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy., Chiovato L; Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy.
Jazyk: angličtina
Zdroj: Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2019 Jan 17; Vol. 9, pp. 813. Date of Electronic Publication: 2019 Jan 17 (Print Publication: 2018).
DOI: 10.3389/fendo.2018.00813
Abstrakt: In recent years, immune checkpoint inhibitors (ICIs) had a great impact in cancer therapy. ICIs display a peculiar toxicity profile, which is characterized by autoimmune-like manifestations against multiple organs, including endocrine glands. We hereby report the case history of two patients who experienced nivolumab-induced endocrine immuno-related adverse events (irAEs). Thyroid dysfunction in both patients presented with a low serum level of TSH. However, endocrine evaluation showed a completely different etiology and clinical evolution. The two patients' histories indicate that nivolumab can cause a large spectrum of thyroid and endocrine dysfunctions resulting in cumbersome diagnostic problems. In these peculiar patients the evaluation of endocrine experts is warranted.
Databáze: MEDLINE
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