PD-1抑制剂所致甲状腺毒症1例报告
Thyrotoxicosis induced by PD-1 inhibitor: a case report
-
摘要: 本文报道了1例由程序性死亡受体-1(programmed death-1,PD-1)抑制剂引起的甲状腺毒症。患者为45岁女性,诊断为转移性鳞癌,首次用PD-1抑制剂帕博利珠单抗(pembrolizumab)后18天时出现了胸闷、心悸、多汗、食欲增加。实验室检查发现游离三碘甲状腺原氨酸(free triiodothyronine, fT3)及游离甲状腺素(free thyroxine, fT4)明显高于帕博利珠单抗治疗前水平,考虑PD-1抑制剂诱发的自身免疫甲状腺炎。给予β受体阻滞剂后,患者胸闷、心悸等症状缓解。建议对接受PD-1抑制剂治疗中的患者,应加强监测甲状腺激素水平及甲状腺自身抗体,尤其是治疗初1-2月,以及时发现、鉴别甲状腺功能异常的病因,给予适当治疗。Abstract: We report a case of thyrotoxicosis caused by a PD-1 (programmed death-1) inhibitor. The patient was a 45-year-old female diagnosed with metastatic squamous cell carcinoma. She experienced palpitation, hyperhidrosis and increased appetite 18 days after first PD-1 inhibitor pembrolizumab administration. Laboratory examinations showed elevated free triiodothyronine and free thyroxine, indicating autoimmune thyroiditis caused by PD-1 inhibitor. Her clinical symptoms were relieved afterβ-blocker was used. This case suggested us to strengthen the monitoring of thyroid function and antithyroid antibody levels in patients receiving PD-1 inhibitors, especially in the first 1-2 months of treatment and thus to timely identify and treat thyroid dysfunction.