Int J Thyroidol.  2018 Nov;11(2):172-175. 10.11106/ijt.2018.11.2.172.

A Case of Aggravation of Thyroid Goiter after Treatment with PD-1 Inhibitor for Breast Cancer in Patients with Underlying Hashimoto's Thyroiditis

• Kim H
• Kim MJ
• Song YS
• Cho SW

• KMID: 2448989
• DOI: http://doi.org/10.11106/ijt.2018.11.2.172

Abstract

Anti-programmed cell death-1 (PD-1) humanized monoclonal antibody inhibits PD-1 activity by binding to the PD-1 receptor on T-cells and blocking PD-1 ligands and induces immune tolerance of cancer cells. It has been widely used for various kinds of cancer treatment. However, many immune-related adverse events (irAEs) have been reported because it modulates our immune system. In this case study, we reported a case of 42-year-old woman with Hashimoto's thyroiditis who showed rapid aggravation of thyroid goiter and acute hyperventilation syndrome after treatment with PD-1 inhibitor as a neoadjuvant chemotherapy for breast cancer.

Keyword

PD-1 inhibitor; Immune-related adverse events (irAEs); Hashimoto's thyroiditis; Goiter

MeSH Terms

Adult
Breast Neoplasms*
Breast*
Drug Therapy
Female
Goiter*
Humans
Hyperventilation
Immune System
Immune Tolerance
Ligands
Programmed Cell Death 1 Receptor
T-Lymphocytes
Thyroid Gland*
Thyroiditis*
Ligands
Programmed Cell Death 1 Receptor

Figure

• 

  Fig. 1. Representative images of thyroid ultrasonography. (A) Diffuse enlargement of goiter and increased blood flow in left thyroid gland at the time of respiratory distress. (B) The size of right middle lobe was 25.9×28.2×45.7 mm at the time of respiratory distress. (C) Twenty days after treatment with prednisolone, the size of right thyroid middle lobe was 22.9×15.0×43.8 mm and the volume decreased by 54%.

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