Drug-induced graves disease from CTLA-4 receptor suppression.
Monoclonal antibody, ipilimumab, useful for treatment of metastatic melanoma, blocks CTLA-4 mediated T-cell suppression and can also cause a Graves ophthalmopathy like syndrome. Epidemiologic study has linked variant polymorphisms of CTLA-4 receptor gene to the presence of thyroid eye disease. The combination of these observations suggests CTLA-4 mediated T-cell functions are important to the pathogenesis of thyroid-associated eye disease.
Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02142, USA. borodic@aol.com
Gary
G
Borodic
David M
DM
Hinkle
Yihong
Y
Cia
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D015703:Antigens, CD / Q000187:drug effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D060908:CTLA-4 Antigen; D004172:Diplopia / Q000139:chemically induced; D005094:Exophthalmos / Q000139:chemically induced; D005260:Female; D049970:Graves Ophthalmopathy / Q000139:chemically induced*; D006801:Humans; D000074324:Ipilimumab; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000188:drug therapy / Q000556:secondary; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy / Q000473:pathology; D009801:Oculomotor Muscles / Q000187:drug effects
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D000970:Antineoplastic Agents; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; D000074324:Ipilimumab