Iadarola Carmine, Croce Laura, Quaquarini Erica, Teragni Cristina, Pinto Sara, Bernardo Antonio, Fonte Rodolfo, Marinò Michele, Rotondi Mario, Chiovato Luca
Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy.
University of Pavia, Dottorato in Medicina Sperimentale, Pavia, Italy.
Front Endocrinol (Lausanne). 2019 Jan 17;9:813. doi: 10.3389/fendo.2018.00813. eCollection 2018.
In recent years, immune checkpoint inhibitors (ICIs) had a great impact in cancer therapy. ICIs display a peculiar toxicity profile, which is characterized by autoimmune-like manifestations against multiple organs, including endocrine glands. We hereby report the case history of two patients who experienced nivolumab-induced endocrine immuno-related adverse events (irAEs). Thyroid dysfunction in both patients presented with a low serum level of TSH. However, endocrine evaluation showed a completely different etiology and clinical evolution. The two patients' histories indicate that nivolumab can cause a large spectrum of thyroid and endocrine dysfunctions resulting in cumbersome diagnostic problems. In these peculiar patients the evaluation of endocrine experts is warranted.
近年来，免疫检查点抑制剂（ICIs）在癌症治疗中产生了重大影响。ICIs表现出独特的毒性特征，其特点是针对包括内分泌腺在内的多个器官出现类似自身免疫的表现。我们在此报告两例经历纳武利尤单抗诱导的内分泌免疫相关不良事件（irAEs）的患者病史。两名患者的甲状腺功能障碍均表现为血清促甲状腺激素（TSH）水平降低。然而，内分泌评估显示病因和临床演变完全不同。这两名患者的病史表明，纳武利尤单抗可导致广泛的甲状腺和内分泌功能障碍，从而引发棘手的诊断问题。对于这些特殊患者，有必要进行内分泌专家评估。
