Shiraishi Jun, Koyama Hidenori, Seki Miwako, Hatayama Miki, Naka Mariko, Kurajoh Masafumi, Okazaki Hirokazu, Shoji Takuhito, Moriwaki Yuji, Yamamoto Tetsuya, Tsuchida Yasuaki, Tsukamoto Yoshitane, Hirota Seiichi, Onoda Naoyoshi, Namba Mitsuyoshi
Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Japan.
Intern Med. 2015;54(6):611-6. doi: 10.2169/internalmedicine.54.3446. Epub 2015 Jan 15.
Anaplastic thyroid carcinoma is a rare disease, and cases associated with eosinophilia are even rarer. We herein report a case of anaplastic thyroid carcinoma accompanied by remarkable and uncontrollable eosinophilia. A 71-year-old man was diagnosed with end-stage anaplastic thyroid carcinoma. Throughout the aggressive clinical course of the cancer, eosinophilia dramatically progressed and became extremely refractory to steroid treatment. We measured the serum levels of hematopoietic cytokines potentially involved in eosinophilia, including granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-3 and IL-5. Although the GM-CSF level was moderately elevated, both the IL-3 and IL-5 levels were within the normal ranges. In this case, the patient's eosinophilia may have been related to his severe dyspnea and was likely responsible for the allergic reaction to the anticancer drug. Therefore, it is essential to elucidate the etiology of eosinophilia in patients with thyroid cancer in order to improve the treatment for patients with anaplastic thyroid carcinoma.
间变性甲状腺癌是一种罕见疾病，而与嗜酸性粒细胞增多相关的病例更为罕见。我们在此报告一例伴有显著且难以控制的嗜酸性粒细胞增多的间变性甲状腺癌病例。一名71岁男性被诊断为晚期间变性甲状腺癌。在癌症的整个侵袭性临床过程中，嗜酸性粒细胞增多显著进展，且对类固醇治疗变得极其难治。我们检测了可能参与嗜酸性粒细胞增多的造血细胞因子的血清水平，包括粒细胞-巨噬细胞集落刺激因子（GM-CSF）、白细胞介素（IL）-3和IL-5。尽管GM-CSF水平中度升高，但IL-3和IL-5水平均在正常范围内。在该病例中，患者的嗜酸性粒细胞增多可能与他的严重呼吸困难有关，并且可能是对抗癌药物过敏反应的原因。因此，阐明甲状腺癌患者嗜酸性粒细胞增多的病因对于改善间变性甲状腺癌患者的治疗至关重要。
