title: [Thyroid and lipidic dysfunction associated with bexarotene in cutaneous T-cell lymphoma].
abstract: OBJECTIVE
  Bexarotene is a synthetic selective X receptor rexinoide approved for the systemic treatment of cutaneous T-cell lymphoma. During treatment is very frequent the occurrence of hypothyroidism and severe mixed hyperlipidemia, both are reversibles and dose-dependent adverse events. Increase of triglycerides and LDL-cholesterol level (up to even higher levels have been associated with pancreatitis in some cases) is widely described (as is the case with other retinoids) but decrease in HDL-cholesterol is poored know. We review our experience with the use of bexarotene.
  
  
  METHODS
  We present a serie of 3 clinical report of patients treated with bexarotene in whose, in addition to these well-known adverse event, a serious lowering of HDL-cholesterol was observed.
  
  
  RESULTS
  The 3 patients studied had metabolic complications like central hypothyroidism and severe mixed hyperlipidemia; with special emphasis on the sharp fall (mean decrease>83%) in the HDL-cholesterol level. Cholesterol lowering medication and substitutive hormonal replacement with levotiroxine resulted in an improvement of the biochimical parameters without reaching the correct goals.
  
  
  CONCLUSIONS
  Bexarotene produce as predictable side effects severe mixed hyperlipidemia with marked decrease in HDL-cholesterol levels and central hypothyroidism, being the both reversible and dose-dependent. A reflection on the possible aetiological mechanisms and implications of this phenomenon are included.
authors.affiliation: Unidad de Riesgo Cardiovascular, Unidad Clínica de Atención Médica Integral, Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: santiagorodriguezes@gmail.com.
authors.forename: Santiago
authors.initials: S
authors.lastname: Rodriguez Suarez
authors.affiliation: Unidad de Riesgo Cardiovascular, Unidad Clínica de Atención Médica Integral, Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Encarnación
authors.initials: E
authors.lastname: Pamies Andreu
authors.affiliation: Unidad de Riesgo Cardiovascular, Unidad Clínica de Atención Médica Integral, Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Ovidio
authors.initials: O
authors.lastname: Muñiz Grijalvo
authors.affiliation: Unidad de Riesgo Cardiovascular, Unidad Clínica de Atención Médica Integral, Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: José Salvador
authors.initials: JS
authors.lastname: Garcia Morillo
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077610:Bexarotene; D008076:Cholesterol, HDL / Q000097:blood; D003131:Combined Modality Therapy; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007037:Hypothyroidism / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000188:drug therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D018714:Radiotherapy, Adjuvant; D016879:Salvage Therapy; D012751:Sezary Syndrome / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000628:therapy; D013764:Tetrahydronaphthalenes / Q000008:administration & dosage / Q000009:adverse effects*; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene; D013974:Thyroxine
keywords: Bexarotene; Bexaroteno; Cholesterol; Colesterol; Cutaneous T-cell lymphoma; Función tiroidea; Linfoma cutáneo de células T; Thyroid function