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Nivolumab Induced Thyroid Dysfunction: Unusual Clinical Presentation and Challenging Diagnosis
Carmine Iadarola1, Laura Croce1,2, Erica Quaquarini2,3
1Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy.
Frontiers in Endocrinology
|February 2, 2019
Summary
Immune checkpoint inhibitors (ICIs) like nivolumab can cause diverse thyroid and endocrine issues in cancer patients. These immune-related adverse events (irAEs) present diagnostic challenges, necessitating expert endocrine evaluation.
Area of Science:
- Oncology
- Immunology
- Endocrinology
Background:
- Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy.
- ICIs are associated with unique autoimmune-like toxicities affecting various organs, including endocrine glands.
Observation:
- This report details two patients experiencing nivolumab-induced endocrine immuno-related adverse events (irAEs).
- Both patients presented with thyroid dysfunction, characterized by low serum TSH levels.
Findings:
- Despite similar initial thyroid findings, the underlying etiology and clinical progression differed significantly between the two patients.
- Nivolumab can induce a wide range of thyroid and endocrine dysfunctions, complicating diagnosis.
Implications:
- The diverse presentations of nivolumab-induced endocrine irAEs pose diagnostic challenges.
- Evaluation by endocrine experts is crucial for managing these complex cases.
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