Severe thyrotoxicosis induced by tislelizumab: a case report and literature review
Immune checkpoint inhibitors (ICIs) have made significant breakthroughs in the treatment of a variety of malignancies. As its use increases, the unique immune-mediated toxicity profile of ICls are becoming apparent. We report a case of immune-related endocrine adverse events (irAE) in a patient with...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-10-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1190491/full |
| _version_ | 1797667872104775680 |
|---|---|
| author | Liman Huo Chao Wang Haixia Ding Xuelian Shi Bin Shan Ruoying Zhou Ping Liang Juan Hou |
| author_facet | Liman Huo Chao Wang Haixia Ding Xuelian Shi Bin Shan Ruoying Zhou Ping Liang Juan Hou |
| author_sort | Liman Huo |
| collection | DOAJ |
| description | Immune checkpoint inhibitors (ICIs) have made significant breakthroughs in the treatment of a variety of malignancies. As its use increases, the unique immune-mediated toxicity profile of ICls are becoming apparent. We report a case of immune-related endocrine adverse events (irAE) in a patient with hepatocellular carcinoma treated with anti-programmed cell death protein 1 (PD-1) (tislelizumab). Although many irAEs have been reported, few cases of severe thyrotoxicosis have been described after immunotherapy in the literature. We present the case of a 49-year-old male who experienced a Grade 3 tislelizumab-related adverse reaction according to Common Terminology Criteria for Adverse Events (CTCAE5.0) and received methylprednisolone, thiamazole, and levothyroxine sodium tablets. Early identification of irAEs, risk factors, regular monitoring, use of steroids and/or immunoglobulins, and adjuvant supportive care are critical to the clinical prognosis of patients. It should be underlined that the tumor benefits of ICI therapy outweigh the risks associated with ICI-induced endocrine disorders, and ICI treatment should not be stopped or delayed except in rare cases (adrenal crisis, severe thyrotoxicosis). The familiarity of healthcare professionals with irAEs of the thyroid when thyrotoxicosis occurs is important to facilitate an effective diagnosis and appropriate treatment of this increasingly common thyroid disorder. |
| first_indexed | 2024-03-11T20:20:51Z |
| format | Article |
| id | doaj.art-dab171483fbe43f986ed9d7dfef5c273 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-11T20:20:51Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-dab171483fbe43f986ed9d7dfef5c2732023-10-03T06:45:38ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-10-011310.3389/fonc.2023.11904911190491Severe thyrotoxicosis induced by tislelizumab: a case report and literature reviewLiman Huo0Chao Wang1Haixia Ding2Xuelian Shi3Bin Shan4Ruoying Zhou5Ping Liang6Juan Hou7Department of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Hepatobiliary Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Endocrinology, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Pain, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Pharmacy, Anguo Hospital, Baoding, ChinaDepartment of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaImmune checkpoint inhibitors (ICIs) have made significant breakthroughs in the treatment of a variety of malignancies. As its use increases, the unique immune-mediated toxicity profile of ICls are becoming apparent. We report a case of immune-related endocrine adverse events (irAE) in a patient with hepatocellular carcinoma treated with anti-programmed cell death protein 1 (PD-1) (tislelizumab). Although many irAEs have been reported, few cases of severe thyrotoxicosis have been described after immunotherapy in the literature. We present the case of a 49-year-old male who experienced a Grade 3 tislelizumab-related adverse reaction according to Common Terminology Criteria for Adverse Events (CTCAE5.0) and received methylprednisolone, thiamazole, and levothyroxine sodium tablets. Early identification of irAEs, risk factors, regular monitoring, use of steroids and/or immunoglobulins, and adjuvant supportive care are critical to the clinical prognosis of patients. It should be underlined that the tumor benefits of ICI therapy outweigh the risks associated with ICI-induced endocrine disorders, and ICI treatment should not be stopped or delayed except in rare cases (adrenal crisis, severe thyrotoxicosis). The familiarity of healthcare professionals with irAEs of the thyroid when thyrotoxicosis occurs is important to facilitate an effective diagnosis and appropriate treatment of this increasingly common thyroid disorder.https://www.frontiersin.org/articles/10.3389/fonc.2023.1190491/fulltislelizumabimmune-related adverse eventshyperthyroidismhypothyroidismthyroiditis |
| spellingShingle | Liman Huo Chao Wang Haixia Ding Xuelian Shi Bin Shan Ruoying Zhou Ping Liang Juan Hou Severe thyrotoxicosis induced by tislelizumab: a case report and literature review Frontiers in Oncology tislelizumab immune-related adverse events hyperthyroidism hypothyroidism thyroiditis |
| title | Severe thyrotoxicosis induced by tislelizumab: a case report and literature review |
| title_full | Severe thyrotoxicosis induced by tislelizumab: a case report and literature review |
| title_fullStr | Severe thyrotoxicosis induced by tislelizumab: a case report and literature review |
| title_full_unstemmed | Severe thyrotoxicosis induced by tislelizumab: a case report and literature review |
| title_short | Severe thyrotoxicosis induced by tislelizumab: a case report and literature review |
| title_sort | severe thyrotoxicosis induced by tislelizumab a case report and literature review |
| topic | tislelizumab immune-related adverse events hyperthyroidism hypothyroidism thyroiditis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1190491/full |
| work_keys_str_mv | AT limanhuo severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT chaowang severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT haixiading severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT xuelianshi severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT binshan severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT ruoyingzhou severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT pingliang severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview AT juanhou severethyrotoxicosisinducedbytislelizumabacasereportandliteraturereview |