Reversible elevation of creatine kinase and creatinine caused by sintilimab-induced hypothyroidism: A case report.

Autor:	Liu SR; Department of Oncology, Sunshine Union Hospital, Weifang, Shandong Province, China., Zhao ZG; Department of Gastroenterology, Beijing Puxiang Hospital Of TCM, Beijing, China., Zhai RR; Department of Oncology, Sunshine Union Hospital, Weifang, Shandong Province, China., Wang LJ; Department of Oncology, Sunshine Union Hospital, Weifang, Shandong Province, China., Yang C; Department of Hematology and Oncology, Laoshan Medical District of No. 971 Hospital of Chinese Navy, Qingdao, Shandong Province, China., Ma QB; Department of Oncology, Sunshine Union Hospital, Weifang, Shandong Province, China., Wang L; Department of Oncology, Sunshine Union Hospital, Weifang, Shandong Province, China.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2024 Oct 18; Vol. 103 (42), pp. e40080.
DOI:	10.1097/MD.0000000000040080
Abstrakt:	Rationale: Programmed cell death (PD) -1 inhibitors has significantly improved the prognosis of cancer patients by enhancing antitumor immune responses. However, PD-1 inhibitors are associated with immune-related adverse events, some of which are rare and potentially life-threatening. Thus far, elevated creatine kinase (CK) and creatinine caused by a novel PD-1 inhibitor (sintilimab)-induced hypothyroidism has not yet been reported. Patient Concerns: A 63-year-old male patient with esophageal cancer who developed hypothyroidism accompanied by unexplained increases in CK and creatinine after sintilimab treatment. Diagnosis: Since the increases in CK and creatinine paralleled the decrease in thyroxine, after excluding other potential conditions, we speculated that the muscular and renal dysfunction might be caused by sintilimab-induced hypothyroidism. Interventions and Outcomes: As the patient's thyroid function improved with levothyroxine replacement therapy, the levels of CK and creatinine concomitantly returned to normal. Conclusion and Lessons: The elevated CK and creatinine levels in this patient were caused by sintilimab-induced hypothyroidism. Our case highlights the importance of keeping PD-1 induced hypothyroidism in mind when patients present with unexplained increased levels of CK and creatinine. Hypothyroidism-related muscular and renal dysfunctions, which can be restored with thyroid hormone replacement, need to be identified early and treated promptly so that unnecessary examinations and treatments can be avoided in these patients. Competing Interests: The authors have no funding and conflicts of interest to disclose. (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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