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題名 | Thyroid Storm Provoked by Interleukin-2 Therapy for Metastatic Melanoma=使用Interleukin-2治療轉移性黑色素瘤後引發之甲狀腺風暴 |
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作者 | 劉耀中; 胡名宏; 楊元豪; 高志平; 劉俊煌; Liu, Yao-chung; Hu, Ming-hung; Yang, Yuan-hao; Gau, Jyh-pyng; Liu, Jin-hwang; |
期刊 | 臺灣癌症醫學雜誌 |
出版日期 | 20140600 |
卷期 | 1:1 2014.06[民103.06] |
頁次 | 頁75-81 |
分類號 | 418.29 |
語文 | eng |
關鍵詞 | 免疫治療; 白細胞介素-2; 黑色素瘤; 甲狀腺風暴; Immunotherapy; Interleukin-2; Melanoma; Thyroid storm; |
中文摘要 | 隨著使用越來越多的免疫療法用在治療癌症和自身免疫性疾病方面,治療後引發嚴 重的自身免疫性甲狀腺功能障礙情況可能也隨之增多。因此,我們報導了一位 49 歲的男 性患者使用白細胞介素-2 (interleukin-2)治療轉移性黑色素瘤後引發之危及生命的甲狀腺 風暴病例。病患本身是一位黑色素瘤併肺轉移患者,並無過去甲狀腺功能異常病史。對於病患的轉移性黑色素瘤,他接受合併免疫藥物合併化學治療 (interleukin-2+ dacarbazine)。在第三次接受免疫化療過程中,產生甲狀腺風暴症狀與情況,其表現為發 燒,心動過速,甚至短暫的心臟停止。幸運的是,在抗甲狀腺藥物治療後,他終於從這 次甲狀腺風暴中恢復。我們的病例焦點在白細胞介素-2 (interleukin-2) 治療後引發之罕見 甲狀腺風暴的併發症。為避免危及生命的併發症產生,所以在使用 interleukin-2 或一些新 發展的免疫治療時,更須注意免疫性甲狀腺功能異常產生之狀況。 |
英文摘要 | With the growing use of immunotherapy in the treatment of cancer and autoimmune disease, severe autoimmune thyroid dysfunction may be provoked at an increasing rate. We herein report a 49-year-old male patient experiencing a life- threatening thyroid storm provoked by interleukin-2 (IL-2). This was a case of pulmonary metastasis of melanoma without a previous history of thyroid dysfunction. For the metastatic melanoma, he underwent combined immunochemotherapy including dacarbazine and IL-2. The 3rd course of immunochemotherapy was complicated with a thyroid storm manifested by high fever, tachycardia and even transient cardiac arrest. Fortunately, he recovered eventually from this crisis by immediate resuscitation followed by antithyroid dugs. Our case highlights the rare complication of a thyroid storm provoked by IL-2 treatment. Precaution against autoimmune thyroid dysfunction is required during treatment with IL-2 and probably also other kinds of newly-developed immunotherapy to avoid life-threatening complications. |
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