Narantsatsral Daramjav, Junko Takagi, Hideyuki Iwayama, Daisuke Inukai, Hiroyuki Takama, Yuka Nomura, Syo Hirase, Hiroyuki Morita, Kazuo Otake, Tetsuya Ogawa, Akiyoshi Takami
Division of Endocrinology and Metabolism, Department of Internal Medicine.
Department of Pediatrics, Aichi Medical University School of Medicine, Nagakute, Japan.
Endocrinol Diabetes Metab Case Rep. 2020 Jun 16;2020. doi: 10.1530/EDM-20-0030.
Dupilumab an inhibitor of the interleukin (IL)-4R-alpha subunit is used for the treatment of allergic diseases. The patient was a 49-year-old man who received dupilumab for the treatment of severe atopic dermatitis. He presented hyperthyroidism with elevated thyroglobulin and anti-thyroid antibody negativity at 4 months after the initiation of therapy. On scintigraphy, the thyroid radioiodine uptake was low. Ultrasonography showed a diffuse hypoechoic area in the thyroid gland. A pathological study revealed lymphocytic infiltration. The administration of dupilumab was continued because of his atopic dermatitis that showed an excellent response. The patient`s hyperthyroidism changed to hypothyroidism 3 weeks later. Six months later his thyroid function normalized without any treatment. We herein describe the case of a patient with atopic dermatitis who developed painless thyroiditis under treatment with dupilumab. To the best of our knowledge, this is the first report of this event in the literature.
Dupilumab, a fully human monoclonal antibody that blocks interleukin-4 and interleukin-13, has been shown to be effective in the treatment atopic dermatitis and asthma with eosinophilia. Painless thyroiditis is characterized by transient hyperthyroidism and hypothyroidism and recovery without anti-thyroid treatment. This is the first report of painless thyroiditis as an adverse effect of dupilumab, although conjunctivitis and nasopharyngitis are the main adverse effects of dupilumab.
度普利尤单抗是一种白细胞介素（IL）-4R-α亚基抑制剂，用于治疗过敏性疾病。该患者为一名49岁男性，接受度普利尤单抗治疗严重特应性皮炎。在治疗开始4个月后，他出现甲状腺功能亢进，甲状腺球蛋白升高且抗甲状腺抗体阴性。在闪烁扫描中，甲状腺放射性碘摄取较低。超声检查显示甲状腺内有弥漫性低回声区。病理研究显示淋巴细胞浸润。由于他的特应性皮炎反应良好，度普利尤单抗的给药继续进行。3周后，患者的甲状腺功能亢进转变为甲状腺功能减退。6个月后，他的甲状腺功能在未接受任何治疗的情况下恢复正常。我们在此描述了一名在度普利尤单抗治疗下发生无痛性甲状腺炎的特应性皮炎患者的病例。据我们所知，这是文献中关于该事件的首例报告。
度普利尤单抗是一种完全人源化单克隆抗体，可阻断白细胞介素-4和白细胞介素-13，已被证明在治疗伴有嗜酸性粒细胞增多的特应性皮炎和哮喘方面有效。无痛性甲状腺炎的特征是短暂的甲状腺功能亢进和减退，且无需抗甲状腺治疗即可恢复。这是关于度普利尤单抗不良反应导致无痛性甲状腺炎的首例报告，尽管结膜炎和鼻咽炎是度普利尤单抗的主要不良反应。
