TY - JOUR
T1 - Extreme hypothyroidism associated with sunitinib treatment for metastatic renal cancer
AU - Del Fabbro, Egidio
AU - Dev, Rony
AU - Cabanillas, Maria E.
AU - Busaidy, Naifa L.
AU - Rodriguez, Eden Mae C.
AU - Bruera, Eduardo
PY - 2012/8
Y1 - 2012/8
N2 - Although thyroid abnormalities are reported with the use of tyrosine kinase inhibitors, patients rarely require replacement therapy. The initial multicentre studies of sunitinib for metastatic renal cancer did not report hypothyroidism in fatigued patients, and thyroid tests were not routinely monitored. More recent studies, however, suggest that up to 70% of patients develop thyroid test abnormalities during treatment with sunitinib. Despite these concerns, the clinical relevance of sunitinib-induced hypothyroidism is uncertain since thyroid gland recovery is the norm in most patients. We report a case of a patient with metastatic papillary renal cell cancer on combination anti-angiogenic therapy with sunitinib, who developed unusually high thyroid stimulating hormone levels and severe symptoms despite receiving L-thyroxine. Our case also illustrates the complexity of managing sunitinib-associated thyroid dysfunction, which may be accompanied by transient thyroiditis, hyperthyroidism, and profound hypothyroidism.
AB - Although thyroid abnormalities are reported with the use of tyrosine kinase inhibitors, patients rarely require replacement therapy. The initial multicentre studies of sunitinib for metastatic renal cancer did not report hypothyroidism in fatigued patients, and thyroid tests were not routinely monitored. More recent studies, however, suggest that up to 70% of patients develop thyroid test abnormalities during treatment with sunitinib. Despite these concerns, the clinical relevance of sunitinib-induced hypothyroidism is uncertain since thyroid gland recovery is the norm in most patients. We report a case of a patient with metastatic papillary renal cell cancer on combination anti-angiogenic therapy with sunitinib, who developed unusually high thyroid stimulating hormone levels and severe symptoms despite receiving L-thyroxine. Our case also illustrates the complexity of managing sunitinib-associated thyroid dysfunction, which may be accompanied by transient thyroiditis, hyperthyroidism, and profound hypothyroidism.
KW - Extreme hypothyroidism
KW - Sunitinib
KW - Symptoms
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U2 - 10.1179/1973947812Y.0000000022
DO - 10.1179/1973947812Y.0000000022
M3 - Article
C2 - 23040687
AN - SCOPUS:84866240086
SN - 1120-009X
VL - 24
SP - 221
EP - 225
JO - Journal of Chemotherapy
JF - Journal of Chemotherapy
IS - 4
ER -