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Open Access 01-12-2018 | Case report

Combination therapy of ipilimumab and nivolumab induced thyroid storm in a patient with Hashimoto’s disease and diabetes mellitus: a case report

Authors: Kazuko Yonezaki, Toshihiro Kobayashi, Hitomi Imachi, Takuo Yoshimoto, Fumi Kikuchi, Kensaku Fukunaga, Seisuke Sato, Tomohiro Ibata, Nao Yamaji, Jingya Lyu, Tao Dong, Koji Murao

Published in: Journal of Medical Case Reports | Issue 1/2018

Abstract

Background

Recently, immune checkpoint inhibitors have widely been used for the management of advanced melanoma. However, high-grade immune-related adverse events can occur, particularly with combination immunotherapy. We report a case of a patient with melanoma who developed thyroid storm following treatment with ipilimumab and nivolumab.

Case presentation

An 85-year-old Japanese man with a history of malignant melanoma presented to our department with severe thyrotoxicosis and poor blood glucose control. He was already being treated for Hashimoto’s disease and type 2 diabetes mellitus before the treatment for the melanoma. During admission, laboratory investigations revealed the following thyroid functions: thyroid-stimulating hormone below sensitivity, free triiodothyronine 31.7 pg/ml, and thyroglobulin 48,000 IU/ml. Thyroid-stimulating hormone receptor antibody was negative, and a ^99mTc-labeled thyroid scan revealed a markedly decreased uptake. He was treated with beta-blocker, orally administered potassium iodine, a relatively low dose of prednisolone, and insulin injection therapy to control his blood glucose, resulting in an improvement in thyroid function and his symptoms.

Conclusion

It might be important to be aware of the possibility of thyroid storm induced by immune checkpoint inhibitors.

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Title: Combination therapy of ipilimumab and nivolumab induced thyroid storm in a patient with Hashimoto’s disease and diabetes mellitus: a case report
Authors: Kazuko Yonezaki
Toshihiro Kobayashi
Hitomi Imachi
Takuo Yoshimoto
Fumi Kikuchi
Kensaku Fukunaga
Seisuke Sato
Tomohiro Ibata
Nao Yamaji
Jingya Lyu
Tao Dong
Koji Murao
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-018-1708-x

At a glance: The STEP trials

Springer Medicine

Combination therapy of ipilimumab and nivolumab induced thyroid storm in a patient with Hashimoto’s disease and diabetes mellitus: a case report

Abstract

Background

Case presentation

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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