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Auto-immune thyroid dysfunction induced by tyrosine kinase inhibitors in a patient with recurrent chordoma

Abstract : 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. 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. 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.
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https://hal.univ-lille.fr/hal-02535993
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Soumis le : mercredi 2 septembre 2020 - 11:34:56
Dernière modification le : mardi 22 septembre 2020 - 10:00:03

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Juliette Eroukhmanoff, Frederic Castinetti, Nicolas Penel, Sébastien Salas. Auto-immune thyroid dysfunction induced by tyrosine kinase inhibitors in a patient with recurrent chordoma. BMC Cancer, BioMed Central, 2016, BMC Cancer, 16, ⟨10.1186/s12885-016-2705-3⟩. ⟨hal-02535993⟩

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