Hypothyroidism as an immune-related adverse event caused by atezolizumab in a patient with muscle spasms: a case report

A 60-year-old man with a history of 4 cycles of atezolizumab treatment for non-small cell lung cancer presented to our hospital with a chief complaint of proximal muscle-dominant spasms. Blood tests showed elevated creatine phosphokinase (CPK) of 8450 U/L and hypothyroidism. There was little improve...

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Published inRespiratory medicine case reports Vol. 36; p. 101585
Main Authors Kawataki, Masanori, Nakanishi, Yosuke, Yokoyama, Toshihide, Ishida, Tadashi
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.01.2022
Elsevier
Subjects
Case Report
hyperCKemia
Hyperthyroidism
Hypothyroidism
Immune checkpoint inhibitors (ICIs)
Immune-related adverse events (irAEs)
Muscle cramps
Immune-related adverse events (irAEs)
Immune checkpoint inhibitors (ICIs)
hyperCKemia
Hyperthyroidism
ICIs
TSH
Hypothyroidism
TPO Ab
Muscle cramps
TRAb
nab-PTX
irAEs
CPK
TRAb, Antithyrotropin receptor antibody
TSH, thyroid stimulating hormone
ICIs, immune checkpoint inhibitors
nab-PTX, nab-paclitaxel
CPK, creatine phosphokinase
irAEs, immune-related adverse events
TPO Ab, Antithyroperoxidase antibody
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Abstract A 60-year-old man with a history of 4 cycles of atezolizumab treatment for non-small cell lung cancer presented to our hospital with a chief complaint of proximal muscle-dominant spasms. Blood tests showed elevated creatine phosphokinase (CPK) of 8450 U/L and hypothyroidism. There was little improvement even after stopping levetiracetam and pregabalin, and no suspicious physical findings of myositis. After levothyroxine was started for hypothyroidism, his muscle cramps and serum CPK level improved. Hypothyroidism as an immune-related adverse event can cause muscle spasms and is important in the differential diagnosis of muscle spasms in patients treated with immune checkpoint inhibitors.
AbstractList A 60-year-old man with a history of 4 cycles of atezolizumab treatment for non-small cell lung cancer presented to our hospital with a chief complaint of proximal muscle-dominant spasms. Blood tests showed elevated creatine phosphokinase (CPK) of 8450 U/L and hypothyroidism. There was little improvement even after stopping levetiracetam and pregabalin, and no suspicious physical findings of myositis. After levothyroxine was started for hypothyroidism, his muscle cramps and serum CPK level improved. Hypothyroidism as an immune-related adverse event can cause muscle spasms and is important in the differential diagnosis of muscle spasms in patients treated with immune checkpoint inhibitors.
A 60-year-old man with a history of 4 cycles of atezolizumab treatment for non-small cell lung cancer presented to our hospital with a chief complaint of proximal muscle-dominant spasms. Blood tests showed elevated creatine phosphokinase (CPK) of 8450 U/L and hypothyroidism. There was little improvement even after stopping levetiracetam and pregabalin, and no subspinous physical findings of myositis. After levothyroxine was started for hypothyroidism, his muscle cramps and serum CPK level improved. Hypothyroidism as an immune-related adverse event can cause muscle spasms and is important in the differential diagnosis of muscle spasms in patients treated with immune checkpoint inhibitors.
ArticleNumber 101585
Author Nakanishi, Yosuke
Kawataki, Masanori
Ishida, Tadashi
Yokoyama, Toshihide
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  surname: Kawataki
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  givenname: Toshihide
  surname: Yokoyama
  fullname: Yokoyama, Toshihide
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  givenname: Tadashi
  surname: Ishida
  fullname: Ishida, Tadashi
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Cites_doi 10.1016/j.autrev.2020.102586
10.1136/rmdopen-2018-000850
10.1007/s11154-018-9463-2
10.12659/AJCR.904691
10.1089/thy.2019.0250
10.1007/s00431-013-2208-z
10.4103/jpn.JPN_133_18
10.1016/j.ejca.2018.09.033
10.1093/annonc/mdy162
10.1146/annurev-med-050219-034237
10.1016/j.ijscr.2016.07.007
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10.1210/er.2018-00006
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Keywords Immune-related adverse events (irAEs)
Immune checkpoint inhibitors (ICIs)
hyperCKemia
Hyperthyroidism
ICIs
TSH
Hypothyroidism
TPO Ab
Muscle cramps
TRAb
nab-PTX
irAEs
CPK
TRAb, Antithyrotropin receptor antibody
TSH, thyroid stimulating hormone
ICIs, immune checkpoint inhibitors
nab-PTX, nab-paclitaxel
CPK, creatine phosphokinase
irAEs, immune-related adverse events
TPO Ab, Antithyroperoxidase antibody
Language English
License This is an open access article under the CC BY-NC-ND license.
2022 The Authors.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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PublicationTitle Respiratory medicine case reports
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Snippet A 60-year-old man with a history of 4 cycles of atezolizumab treatment for non-small cell lung cancer presented to our hospital with a chief complaint of...
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StartPage 101585
SubjectTerms Case Report
hyperCKemia
Hyperthyroidism
Hypothyroidism
Immune checkpoint inhibitors (ICIs)
Immune-related adverse events (irAEs)
Muscle cramps
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Title Hypothyroidism as an immune-related adverse event caused by atezolizumab in a patient with muscle spasms: a case report
URI https://dx.doi.org/10.1016/j.rmcr.2022.101585
https://www.ncbi.nlm.nih.gov/pubmed/35116222
https://pubmed.ncbi.nlm.nih.gov/PMC8792264
https://doaj.org/article/80b72a9b282648f0868edf4931023037
Volume 36
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