Anaplastic Thyroid Carcinoma Accompanied by Uncontrollable Eosinophilia
Anaplastic Thyroid Carcinoma Accompanied by Uncontrollable Eosinophilia
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DOI：
10.2169/internalmedicine.54.3446
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发表时间：
2015-01-01
影响因子：
1.2
通讯作者：
Namba, Mitsuyoshi
中科院分区：
文献类型：
--
作者：
Shiraishi, Jun;Koyama, Hidenori;Namba, Mitsuyoshi
甲状腺未分化癌是一种罕见的疾病，与嗜酸性粒细胞增多症有关的病例更是罕见。我们在此报告一个甲状腺未分化癌的病例，同时伴有显著且无法控制的嗜酸性粒细胞增多症。一名71岁的男子被诊断为终末期甲状腺未分化癌。在整个癌症的侵袭性临床过程中，嗜酸性粒细胞增多症急剧进展，并变得对类固醇治疗极其难治。我们检测了可能参与嗜酸性粒细胞增多症的造血细胞因子的血清水平，包括粒细胞-巨噬细胞集落刺激因子（GM-CSF）、白细胞介素（IL）-3和IL-5。虽然GM-CSF水平中度升高，但IL-3和IL-5水平均在正常范围内。在这种情况下，患者的嗜酸性粒细胞增多症可能与其严重呼吸困难有关，并可能导致对抗癌药物的过敏反应。因此，阐明甲状腺癌患者嗜酸性粒细胞增多的病因，对提高甲状腺未分化癌的治疗水平具有重要意义。
Anaplastic thyroid carcinoma is a rare disease, and cases associated with eosinophilia are even rarer. We herein report a case of anaplastic thyroid carcinoma accompanied by remarkable and uncontrollable eosinophilia. A 71-year-old man was diagnosed with end-stage anaplastic thyroid carcinoma. Throughout the aggressive clinical course of the cancer, eosinophilia dramatically progressed and became extremely refractory to steroid treatment. We measured the serum levels of hematopoietic cytokines potentially involved in eosinophilia, including granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-3 and IL-5. Although the GM-CSF level was moderately elevated, both the IL-3 and IL-5 levels were within the normal ranges. In this case, the patient's eosinophilia may have been related to his severe dyspnea and was likely responsible for the allergic reaction to the anticancer drug. Therefore, it is essential to elucidate the etiology of eosinophilia in patients with thyroid cancer in order to improve the treatment for patients with anaplastic thyroid carcinoma.