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结合免疫检查点抑制剂治疗后甲状腺功能障碍疾病实体亚型的挑战:一个病例报告

Marco Juul Thomsen^1,2, Stine Linding Andersen^3,4, Nanna Maria Uldall Torp^1,2

¹Department of Clinical Biochemistry, Aalborg University Hospital, Hobrovej 18-22, Aalborg, 9000, Denmark.

Thyroid research

|July 14, 2025

概括

免疫检查点抑制剂疗法可能会导致甲状腺快速功能障碍,导致甲状腺毒性和随后的甲状腺功能低下. 密切监测甲状腺功能对于接受免疫治疗的患者至关重要.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
免疫学免疫学免疫学

背景情况:

免疫检查点抑制剂 (ICI) 在晚期癌症治疗中至关重要.
甲状腺功能障碍是ICI治疗的已知副作用,但其亚型和进展需要进一步调查.

研究的目的:

在接受ICI联合治疗的患者中报告一种迅速发作的甲状腺功能障碍病例.
突出诊断挑战和监测免疫治疗期间甲状腺功能临床重要性.

主要方法:

一个51岁的女性患有转移性胰腺癌的病例介绍,她接受了ipilimumab和nivolumab治疗.
内分泌评估包括甲状腺功能测试,抗体水平和超声波.
用抗甲状腺药物进行管理,其次是levothyroxine.

主要成果:

患者在开始ICI治疗的几天内出现了明显的甲状腺毒性,尽管症状很小.
甲状腺超声波显示了一个扩大的,异质的腺体与增加的血管性.
用抗甲状腺药物治疗导致过渡性正常化,随后发展为甲状腺功能低下症,需要开始服用levothyroxine.

结论:

ICI治疗可以诱导快速和连续的甲状腺功能障碍,从甲状腺毒素症到甲状腺功能低下症.
确定ICI诱导的甲状腺功能障碍的亚型存在挑战.
在接受免疫治疗的患者中,对甲状腺功能进行警的临床监测至关重要.

关键词:

在 CTLA-4 中.甲状腺功能过强症甲状腺功能过强症甲状腺功能低下症甲状腺功能低下症与免疫相关的不良事件.在PD-1中使用PD-1.

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