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Thyroid-like ophthalmopathy in a euthyroid patient receiving Ipilimumab
Elizabeth McElnea1, Aine Ní Mhéalóid, Sarah Moran
1Department of Ophthalmology, Mater Misericordiae University Hospital , Dublin , Ireland.
Orbit (Amsterdam, Netherlands)
|September 11, 2014
Summary
Ipilimumab therapy can cause thyroid-like eye disease (orbitopathy) in patients with metastatic melanoma, even if thyroid function tests remain normal. Early thyroid screening is recommended before starting Ipilimumab treatment.
Area of Science:
- Ophthalmology
- Oncology
- Endocrinology
Background:
- Metastatic malignant melanoma is a serious cancer.
- Ipilimumab is an immunotherapy used to treat melanoma.
- Ophthalmoplegia and proptosis are serious eye movement and bulging symptoms.
Observation:
- A 68-year-old female patient treated with Ipilimumab developed bilateral ophthalmoplegia and proptosis.
- Radiological imaging revealed bilateral enlargement of extra-ocular muscles, mimicking thyroid eye disease.
- Laboratory tests confirmed the patient was euthyroid (normal thyroid function).
Findings:
- The patient was diagnosed with thyroid-like orbitopathy secondary to Ipilimumab therapy.
- This condition occurred despite the patient maintaining normal thyroid function.
- Thyroid-like eye disease is a potential side effect of Ipilimumab.
Implications:
- Thyroid function tests are crucial before initiating Ipilimumab treatment.
- Clinicians should be aware of the risk of developing thyroid-like eye disease with Ipilimumab, even in euthyroid patients.
- This finding highlights the importance of monitoring for ocular side effects during immunotherapy.
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