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Case Reports
. 2019 Jan 17:9:813.
doi: 10.3389/fendo.2018.00813. eCollection 2018.

Nivolumab Induced Thyroid Dysfunction: Unusual Clinical Presentation and Challenging Diagnosis

Carmine Iadarola  1 , Laura Croce  1   2 , Erica Quaquarini  2   3 , Cristina Teragni  3 , Sara Pinto  1 , Antonio Bernardo  3 , Rodolfo Fonte  1 , Michele Marinò  4 , Mario Rotondi  1 , Luca Chiovato  1
Affiliations
Case Reports

Nivolumab Induced Thyroid Dysfunction: Unusual Clinical Presentation and Challenging Diagnosis

Carmine Iadarola et al. Front Endocrinol (Lausanne). .

Abstract

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.

Keywords: PD-1; autoimmune; graves' disease; hyperthyroidism; hypothyroidism; immune checkpoint inhibitors; nivolumab; thyroid.

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Figures

Figure 1
Figure 1
Thyroid hormone profile of Case 1.
Figure 2
Figure 2
Thyroid hormone profile of Case 2.
See this image and copyright information in PMC

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