Nilotinib-induced hypothyroidism in a patient with chronic myeloid leukemia
Nilotinib-induced hypothyroidism in a patient with chronic myeloid leukemia
复制标题
慢性粒细胞白血病患者尼洛替尼诱发的甲状腺功能减退症
DOI：
10.1007/s12185-011-0790-2
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发表时间：
2011
影响因子：
2.1
通讯作者：
Kurokawa M
中科院分区：
文献类型：
--
作者：
Yoshizato T;Nannya Y;Yoshiki Y;Nakamura F;Imai Y;Ichikawa M;Kurokawa M
外周水肿常发生在使用激酶抑制剂（TKIs）治疗的慢性髓性白血病（CML）患者中。然而，很少有报道表明水肿是由tkis诱导的甲状腺功能减退引起的。我们提出的情况下，一个76岁的男子慢性慢性粒细胞白血病谁遭受了严重的全身性水肿后引入尼洛替尼。实验室检查显示甲状腺功能减退；患者在引入尼罗替尼之前甲状腺功能正常。进一步检查后，我们将这种甲状腺功能减退归因于尼洛替尼。他的水肿在甲状腺激素替代治疗后显著消退，并继续使用尼洛替尼治疗。甲状腺功能的实验室检查也有明显改善。尽管舒尼替尼是一种多靶点TKI，与甲状腺功能减退的高发相关，但靶向Bcr-Abl的TKI很少被报道导致甲状腺功能减退。我们报道了尼罗替尼引起的甲状腺功能减退，并建议当接受tkis的患者出现水肿时，甲状腺功能减退应被视为可能的病因。
Peripheral edema often occurs in patients with chronic myeloid leukemia (CML) treated with kinase inhibitors (TKIs). However, there are few reports indicating that the edema is caused by TKIs-induced hypothyroidism. We present the case of a 76-year-old man with chronic-phase CML who suffered from severe systemic edema after introduction of nilotinib. Laboratory tests revealed hypothyroidism; the patient was euthyroid prior to introduction of nilotinib. After further examination, we attributed this hypothyroidism to nilotinib. His edema regressed dramatically after thyroid hormone replacement therapy, with continued treatment with nilotinib. Laboratory examination of thyroid function also improved markedly. Although sunitinib, a multi-targeted TKI, is associated with a high incidence of hypothyroidism, TKIs targeting Bcr-Abl have rarely been reported to cause hypothyroidism. We report nilotinib-induced hypothyroidism, and suggest that hypothyroidism should be considered as a possible etiology when patients receivingTKIs suffer from edema.