Article ; Online: A decrease in peripheral thyroid hormone conversion efficiency in patients treated with immune checkpoint inhibitors and L-T3 as a possible alternative therapeutic escape option.
European journal of clinical investigation
2022 Volume 52, Issue 7, Page(s) e13790
Abstract: Hypothyroidism is a frequently occurring side effect in patients under treatment with immune checkpoint inhibitors (ICIs). Actually, the origin of hypothyroidism with ICI use is classified as a primary (thyroid) or as secondary/tertiary hypothyroidism ( ... ...
| Abstract | Hypothyroidism is a frequently occurring side effect in patients under treatment with immune checkpoint inhibitors (ICIs). Actually, the origin of hypothyroidism with ICI use is classified as a primary (thyroid) or as secondary/tertiary hypothyroidism (hypothalamus-pituitary). Treatment consists of levothyroxine (L-T4) substitution. Recently, we were rarely confronted with a clinically overt hypothyroidism in three patients under treatment with ICIs who were non-responsive to T4 therapy. As a therapeutical escape, liothyronine (L-T3) was started with a significant clinical and/or biochemical improvement suggesting an underlying functional defect in the peripheral free T4 (fT4) to free T3 (fT3) conversion (as supported by calculation of SPINA-GD). Against this background, we discussed our three patients along an extended review of this clinical topic. |
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| MeSH term(s) | Humans ; Hypothyroidism/drug therapy ; Hypothyroidism/metabolism ; Immune Checkpoint Inhibitors/therapeutic use ; Thyroid Hormones/metabolism ; Thyroid Hormones/therapeutic use ; Thyrotropin ; Thyroxine/therapeutic use ; Triiodothyronine |
| Chemical Substances | Immune Checkpoint Inhibitors ; Thyroid Hormones ; Triiodothyronine (06LU7C9H1V) ; Thyrotropin (9002-71-5) ; Thyroxine (Q51BO43MG4) |
| Language | English |
| Publishing date | 2022-04-21 |
| Publishing country | England |
| Document type | Journal Article ; Review |
| ZDB-ID | 186196-7 |
| ISSN | 1365-2362 ; 0014-2972 ; 0960-135X |
| ISSN (online) | 1365-2362 |
| ISSN | 0014-2972 ; 0960-135X |
| DOI | 10.1111/eci.13790 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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