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Drug-Induced Graves Disease From CTLA-4 Receptor Suppression
Abstract
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.
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In the citing paper
“To the best of our knowledge at the time of writing, only nine cases of ICPi-induced Graves’ hyperthyroidism and seven cases of induced Graves’ orbitopathy have been described in the literature, associated with anti-PD-1 or anti-CTLA-4 treatment or their combination (Table 3), with only one patient presenting with both thyrotoxicosis and orbitopathy [19,29,30,31,35,36,37,38,39,40,41,42,43,44].”
From Graves’ Disease during Immune Checkpoint Inhibitor Therapy (A Case Series and Literature Review) (2021) · cites this paper as [31]
In the citing paper
“In the literature, initially only induced Graves’ orbitopathy (GO) without thyrotoxicosis were described in patients undergoing Ipilimumab (anti-CTLA-4) treatment [29,30,31].”
From Graves’ Disease during Immune Checkpoint Inhibitor Therapy (A Case Series and Literature Review) (2021) · cites this paper as [31]
In the citing paper
“Human leukocyte antigen (HLA) haplotypes linked with classic T1D (DR3-DQ2 and DR4-DQ8) and fulminant diabetes in the Asian population (DR4-DQ4 and DR9-DQ9) are over-represented among ICI-DM patients68”
From Endocrine toxicities of immune checkpoint inhibitors (2021) · cites this paper as [68]
In the citing paper
“whereas reports of cases on CTLA-4 monotherapy are very rare”
From Endocrine toxicities of immune checkpoint inhibitors (2021) · cites this paper as [68]
In the citing paper
“Approximately 97% of all reported ICI-DM cases have arisen with anti-PD-1/PD-L1 or combination treated patients”
From Endocrine toxicities of immune checkpoint inhibitors (2021) · cites this paper as [68]
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Metadata
- Authors
- Borodic, G., Hinkle, D. M., & Cia, Y.
- Affiliations
- Massachusetts Eye and Ear Infirmary (US)
- Harvard University (US)
- Corresponding author
- Borodic, Gary
- ORCID
- Hinkle, David M.
- Venue
- Ophthalmic Plastic & Reconstructive Surgery
- Published
- 2011-07
- Volume
- 27
- Issue
- 4
- Pages
- e87-e88
- ISSN
- 0740-9303 (ISSN-L)
- OpenAlex
- W1988822265
- Cited by
- 120
- References
- 6
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 6 · 2022: 7 · 2021: 9 · 2020: 9 · 2019: 13 · 2018: 13 · 2017: 7 · 2016: 13 · 2015: 10 · 2014: 4 · 2013: 10 · 2012: 2
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ophthalmic Plastic and Reconstructive Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Ophthalmology › Drug-Induced Ocular Toxicity
- Keywords
- ipilimumab, CTLA-4 blockade, Graves' ophthalmopathy, T cell suppression, metastatic melanoma, CTLA-4 gene polymorphism, autoimmune thyroid disease
- MeSH terms
- Ipilimumab, Antibodies, Monoclonal, Antineoplastic Agents, Diplopia, Exophthalmos, Female, Humans, Lung Neoplasms, Magnetic Resonance Imaging, Melanoma, Middle Aged, Neoplasms, Unknown Primary, Oculomotor Muscles, Antigens, CD, Graves Ophthalmopathy, CTLA-4 Antigen
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