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Case Report

Polyglandular Autoimmune Syndrome Triggered after CTLA-4 and PD-1L Immunotherapy Treatment

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Sección de Endocrinología y Nutrición, Hospital V. Álvarez Buylla, Calle Vistalegre 2, 33611 Mieres del Camino, Asturias, Spain
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Sección de Cardiología, Hospital V. Álvarez Buylla, Calle Vistalegre 2, 33611 Mieres del Camino, Asturias, Spain
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Servicio de Medicina Interna, Hospital V. Álvarez Buylla, Calle Vistalegre 2, 33611 Mieres del Camino, Asturias, Spain
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Servicio de Anestesiología y Reanimación, Hospital Universitario Central de Asturias, Av. De Roma s/n, 33011 Oviedo, Asturias, Spain
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Author to whom correspondence should be addressed.
Academic Editor: Cristoforo Comi
Received: 20 December 2020 / Revised: 12 January 2021 / Accepted: 12 January 2021 / Published: 14 January 2021
(This article belongs to the Special Issue Case Reports of Autoimmune Diseases)
Background: CTLA-4 and PD-1L are novel immune checkpoint targets for cancer treatment with specific side effects such as autoimmune diseases. Less frequently, the presence of several autoimmune diseases in the same patient has been described. In this communication, we illustrate the case of a 45-year-old patient with a previous diagnosis of advanced cancer that, after starting treatment with this immunotherapy, developed in the following months autoimmune diabetes, lymphocytic hypophysitis, and a Hashimoto thyroiditis in an abrupt and intense manner that would correspond to an autoimmune polyglandular disease. Discussion: The activation of autoimmunity and associated diseases is increasing in parallel with augmented indication of these immunotherapeutic treatments in cancer patients. A closer follow-up of these patients could be necessary for an optimal approach to this type of pathology. Conclusions: Different autoimmune diseases can converge in the same patient when immunotherapy for cancer is indicated to boost immune response against tumor, caused by altering immune tolerance. View Full-Text
Keywords: CTLA-4; PD-1L; type 1 diabetes; thyroiditis; hypophysitis; immune tolerance; autoimmunity; immunotherapy CTLA-4; PD-1L; type 1 diabetes; thyroiditis; hypophysitis; immune tolerance; autoimmunity; immunotherapy
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MDPI and ACS Style

Fernández-Morera, J.L.; Renilla González, A.; Calvo Rodríguez, C.E.; Romano-García, J. Polyglandular Autoimmune Syndrome Triggered after CTLA-4 and PD-1L Immunotherapy Treatment. Reports 2021, 4, 1. https://0-doi-org.brum.beds.ac.uk/10.3390/reports4010001

AMA Style

Fernández-Morera JL, Renilla González A, Calvo Rodríguez CE, Romano-García J. Polyglandular Autoimmune Syndrome Triggered after CTLA-4 and PD-1L Immunotherapy Treatment. Reports. 2021; 4(1):1. https://0-doi-org.brum.beds.ac.uk/10.3390/reports4010001

Chicago/Turabian Style

Fernández-Morera, Juan L., Alfredo Renilla González, Carmen E. Calvo Rodríguez, and Judit Romano-García. 2021. "Polyglandular Autoimmune Syndrome Triggered after CTLA-4 and PD-1L Immunotherapy Treatment" Reports 4, no. 1: 1. https://0-doi-org.brum.beds.ac.uk/10.3390/reports4010001

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