AUTHOR=Iadarola Carmine , Croce Laura , Quaquarini Erica , Teragni Cristina , Pinto Sara , Bernardo Antonio , Fonte Rodolfo , Marinò Michele , Rotondi Mario , Chiovato Luca TITLE=Nivolumab Induced Thyroid Dysfunction: Unusual Clinical Presentation and Challenging Diagnosis JOURNAL=Frontiers in Endocrinology VOLUME=9 YEAR=2019 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2018.00813 DOI=10.3389/fendo.2018.00813 ISSN=1664-2392 ABSTRACT=

In recent years, immune checkpoint inhibitors (ICIs) had a great impact in cancer therapy. ICIs display a peculiar toxicity profile, which is characterized by autoimmune-like manifestations against multiple organs, including endocrine glands. We hereby report the case history of two patients who experienced nivolumab-induced endocrine immuno-related adverse events (irAEs). Thyroid dysfunction in both patients presented with a low serum level of TSH. However, endocrine evaluation showed a completely different etiology and clinical evolution. The two patients' histories indicate that nivolumab can cause a large spectrum of thyroid and endocrine dysfunctions resulting in cumbersome diagnostic problems. In these peculiar patients the evaluation of endocrine experts is warranted.