McElnea Elizabeth, Ní Mhéalóid Aine, Moran Sarah, Kelly Rory, Fulcher Tim
Department of Ophthalmology, Mater Misericordiae University Hospital , Dublin , Ireland.
Orbit. 2014 Dec;33(6):424-7. doi: 10.3109/01676830.2014.949792. Epub 2014 Sep 10.
A 68-year-old lady with metastatic malignant melanoma was treated with Ipilimumab. She presented to Eye Casualty unable to move her eyes. Physical examination confirmed ophthalmoplegia and identified proptosis bilaterally. Radiological imaging showed bilateral enlargement of all the extra-ocular muscles suggestive of thyroid eye disease. Laboratory investigations found this patient to be euthyroid. A diagnosis of thyroid-like orbitopathy secondary to Ipilimumab therapy was made. Thyroid function tests should be performed for all patients prior to their commencement of Ipilimumab. Thyroid-like eye disease may develop in patients treated with Ipilimumab even if they remain euthyroid.
一名68岁的转移性恶性黑色素瘤女性患者接受了伊匹单抗治疗。她因无法转动眼球而就诊于眼科急诊。体格检查证实存在眼肌麻痹,并发现双侧眼球突出。影像学检查显示所有眼外肌双侧肿大,提示甲状腺眼病。实验室检查发现该患者甲状腺功能正常。诊断为伊匹单抗治疗继发的类甲状腺眼眶病。所有患者在开始使用伊匹单抗之前均应进行甲状腺功能检查。即使甲状腺功能正常,接受伊匹单抗治疗的患者也可能发生类甲状腺眼病。