Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen

Immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI) have been among the increasingly used antineoplastic agents for advanced cancers including renal cell carcinoma (RCC). Although these antineoplastic agents have broad range of efficacy, rare adverse events - mild and fatal, acut...

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Autores principales: Figueroa-Perez, Nikole, Kashyap, Rahul, Bal, Deepinder, Anjum Khan, Syed, Pattan, Vishwanath
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Endocrinology/Diabetes/Metabolism
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412885/
https://www.ncbi.nlm.nih.gov/pubmed/34513503
http://dx.doi.org/10.7759/cureus.16933
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author Figueroa-Perez, Nikole
Kashyap, Rahul
Bal, Deepinder
Anjum Khan, Syed
Pattan, Vishwanath
author_facet Figueroa-Perez, Nikole
Kashyap, Rahul
Bal, Deepinder
Anjum Khan, Syed
Pattan, Vishwanath
author_sort Figueroa-Perez, Nikole
collection PubMed
description Immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI) have been among the increasingly used antineoplastic agents for advanced cancers including renal cell carcinoma (RCC). Although these antineoplastic agents have broad range of efficacy, rare adverse events - mild and fatal, acute and chronic, immune and non-immune mediated - have been reported. We report a case of a 73-year-old Caucasian male patient with stage IV right-sided clear cell RCC who was treated with a pembrolizumab-axitinib combination regimen and suffered life-threatening, acute onset immune-related myasthenia gravis (MG), subsequently progressive hypothyroidism, and primary adrenal insufficiency.
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spelling pubmed-84128852021-09-09 Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen Figueroa-Perez, Nikole Kashyap, Rahul Bal, Deepinder Anjum Khan, Syed Pattan, Vishwanath Cureus Endocrinology/Diabetes/Metabolism Immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI) have been among the increasingly used antineoplastic agents for advanced cancers including renal cell carcinoma (RCC). Although these antineoplastic agents have broad range of efficacy, rare adverse events - mild and fatal, acute and chronic, immune and non-immune mediated - have been reported. We report a case of a 73-year-old Caucasian male patient with stage IV right-sided clear cell RCC who was treated with a pembrolizumab-axitinib combination regimen and suffered life-threatening, acute onset immune-related myasthenia gravis (MG), subsequently progressive hypothyroidism, and primary adrenal insufficiency. Cureus 2021-08-06 /pmc/articles/PMC8412885/ /pubmed/34513503 http://dx.doi.org/10.7759/cureus.16933 Text en Copyright © 2021, Figueroa-Perez et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Endocrinology/Diabetes/Metabolism
Figueroa-Perez, Nikole
Kashyap, Rahul
Bal, Deepinder
Anjum Khan, Syed
Pattan, Vishwanath
Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen
title Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen
title_full Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen
title_fullStr Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen
title_full_unstemmed Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen
title_short Autoimmune Myasthenia, Primary Adrenal Insufficiency, and Progressive Hypothyroidism Due to Pembrolizumab and Axitinib Combination Regimen
title_sort autoimmune myasthenia, primary adrenal insufficiency, and progressive hypothyroidism due to pembrolizumab and axitinib combination regimen
topic Endocrinology/Diabetes/Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412885/
https://www.ncbi.nlm.nih.gov/pubmed/34513503
http://dx.doi.org/10.7759/cureus.16933
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