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Auto-immune thyroid dysfunction induced by tyrosine kinase inhibitors in a patient with recurrent chordoma
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Auto-immune thyroid dysfunction induced by tyrosine kinase inhibitors in a patient with recurrent chordoma
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Journal Article
Auto-immune thyroid dysfunction induced by tyrosine kinase inhibitors in a patient with recurrent chordoma
2016
Overview
Background
While hypothyroidism has frequently been reported with the use of TKIs, the thyroid-stimulating hormone (TSH) suppressing effect of TKIs is rare, except for thyroiditis. We describe a case with progressive recurrent chordoma who initially became hyperthyroid in a context of autoimmunity under sorafenib treatment and later under imatinib treatment.
Case presentation
A 57-year-old man with lumbar chordoma began daily treatment of 800 mg sorafenib. He did not have any other medication or recent iodinated-contrast exposure and his family history was negative for thyroid and autoimmune disease. There was no history of neck pain, irradiation or trauma, recent fever or viral illness. Pre-treatment TSH was normal. After 18 weeks of treatment, the patient presented hyperthyroidism with positive anti-TSH receptor antibodies. More surprisingly, Graves’ disease recurred during treatment with imatinib.
Conclusion
The fact that Graves’ disease occurred after two different TKIs suggests that it could be a rare but important class effect. Anti-TSH receptor antibodies should be systematically measured when TSH decreases in order to avoid the erroneous diagnosis of transient hyperthyroidism due to thyroiditis.
Publisher
BioMed Central,BioMed Central Ltd
Subject
Antineoplastic Agents - adverse effects
/ Biomedical and Life Sciences
/ Complications and side effects
/ Graves Disease - chemically induced
/ Health Promotion and Disease Prevention
/ Humans
/ Imatinib Mesylate - adverse effects
/ Male
/ Medical and radiation oncology
/ Neoplasm Recurrence, Local - drug therapy
/ Niacinamide - adverse effects
/ Niacinamide - analogs & derivatives
/ Oncology
/ Phenylurea Compounds - adverse effects
