Department of Medicine, American British Cowdray Medical Center. Mexico City, Mexico.
Department of Medical Oncology, Hospital "Luis Vernaza y Solca", Guayaquil, Ecuador.
Gac Med Mex. 2021;157(3):293-297. doi: 10.24875/GMM.M21000560.
Immune checkpoint inhibitors (ICI) are a group of drugs that have been used in recent years for the treatment of advanced malignancies such as melanoma, non-small cell lung cancer and other tumors, significantly increasing survival. However, the use of ICI has been associated with an increased risk of autoimmune diseases, with endocrine organs, specifically the thyroid, being highly susceptible to this phenomenon.
To describe the incidence and clinical characteristics of patients treated with ICI who develop thyroid disease.
The medical records of all patients who received ICI treatment within the last three years were retrospectively reviewed, with those who developed thyroid abnormalities being identified.
The prevalence of thyroiditis was 7 %, with an incidence of 21.4 % of patients-month. Median time for the development of thyroiditis was 63 days. Most patients had mild or moderate symptoms and did not require hospitalization, although all but one developed permanent hypothyroidism and required hormone replacement therapy with levothyroxine.
Thyroid dysfunction secondary to immunotherapy is a common entity in our population. Clinical presentation is usually mild and does not require treatment discontinuation; however, due to the high incidence of these adverse events, non-oncology specialists must be familiar with the diagnosis and treatment of these alterations in order to provide multidisciplinary management.
免疫检查点抑制剂（ICI）是近年来用于治疗黑色素瘤、非小细胞肺癌和其他肿瘤等晚期恶性肿瘤的一类药物，显著提高了患者的生存率。然而，ICI 的使用与自身免疫性疾病的风险增加相关，内分泌器官，特别是甲状腺，对此现象高度敏感。
描述接受 ICI 治疗后发生甲状腺疾病的患者的发病率和临床特征。
回顾性分析过去三年接受 ICI 治疗的所有患者的病历，确定出现甲状腺异常的患者。
甲状腺炎的患病率为 7%，患者月发病率为 21.4%。甲状腺炎的中位发病时间为 63 天。大多数患者症状轻微或中度，无需住院治疗，但除 1 例外，所有患者均发生永久性甲状腺功能减退，需要用左甲状腺素进行激素替代治疗。
免疫治疗引起的甲状腺功能障碍在我们的人群中是一种常见现象。临床表现通常较轻，不需要停止治疗；然而，由于这些不良事件的发生率较高，非肿瘤学专家必须熟悉这些改变的诊断和治疗，以便提供多学科管理。
