Hirooka Masashi, Ochi Hironori, Hiraoka Atsushi, Koizumi Yohei, Matsuura Bunzo, Joko Kouji, Michitaka Kojiro, Abe Masanori, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan.
Center for Liver-Biliary-Pancreatic Diseases, Matsuyama Red Cross Hospital, Japan.
Intern Med. 2019 Mar 15;58(6):791-795. doi: 10.2169/internalmedicine.1874-18. Epub 2018 Oct 17.
Hypothyroidism is a frequently occurring complication in patients on lenvatinib treatment. However, little is known about lenvatinib-induced thyrotoxicosis and destructive thyroiditis. We herein report the cases of three patients who developed hyperthyroidism during the course of lenvatinib treatment. All patients had multiple hepatocellular carcinoma of Child-Pugh class A. Two patients required beta blockers for the management of palpitations. One patient developed hyperthyroidism only one week after the initiation of lenvatinib treatment. Thus, the possibility of hyperthyroidism developing within one week after the first administration should be kept in mind, and periodic surveillance of the thyroid function should be performed during the early period of lenvatinib therapy (within the first two weeks or so after the initial administration).
甲状腺功能减退是乐伐替尼治疗患者中常见的并发症。然而,关于乐伐替尼引起的甲状腺毒症和破坏性甲状腺炎知之甚少。我们在此报告3例在乐伐替尼治疗过程中发生甲状腺功能亢进的患者。所有患者均为Child-Pugh A级多灶性肝细胞癌。2例患者需要使用β受体阻滞剂来控制心悸。1例患者在乐伐替尼治疗开始仅1周后就出现了甲状腺功能亢进。因此,应牢记首次给药后1周内发生甲状腺功能亢进的可能性,并且在乐伐替尼治疗早期(首次给药后的前两周左右)应定期监测甲状腺功能。