McMillen Brock, Dhillon Manvinder Shelley, Yong-Yow Sabrina
Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
BMJ Case Rep. 2016 Apr 18;2016:10.1136/bcr-2016-214603. doi: 10.1136/bcr-2016-214603.
Thyroid storm is a rare and life-threatening state of thyroid hormone excess. Rapid recognition of thyroid storm is key to decreasing the morbidity and mortality of this condition. Clinical manifestations of thyroid storm include unexplained weight loss, hyperactivity and irritability. The most common causes of thyrotoxicosis are Graves' disease, toxic multinodular goitre and toxic adenoma. We present a rare case of thyroid storm induced by dual nivolumab and ipilimumab immunotherapy in a patient receiving treatment for advanced melanoma. In this case, our patient was admitted for thyroid storm 1 month after initiating treatment with nivolumab and ipilimumab immunotherapy. The patient was treated with β-blockers, antithyroid medications and systemic steroids resulting in an improvement in thyroid function testing and symptoms.
甲状腺危象是一种罕见且危及生命的甲状腺激素过量状态。快速识别甲状腺危象是降低该病症发病率和死亡率的关键。甲状腺危象的临床表现包括不明原因的体重减轻、多动和易怒。甲状腺毒症最常见的病因是格雷夫斯病、毒性多结节性甲状腺肿和毒性腺瘤。我们报告了一例在接受晚期黑色素瘤治疗的患者中，由纳武单抗和伊匹单抗双重免疫治疗诱发甲状腺危象的罕见病例。在该病例中，我们的患者在开始使用纳武单抗和伊匹单抗免疫治疗1个月后因甲状腺危象入院。患者接受了β受体阻滞剂、抗甲状腺药物和全身性类固醇治疗，甲状腺功能检查和症状均有所改善。
