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Drug-Induced Autoimmunity

By

Jennifer M. Barker

, MD, Children's Hospital Colorado, Division of Pediatric Endocrinology

Last full review/revision Apr 2021| Content last modified Apr 2021
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Patients receiving drugs in the novel class of cancer therapeutics called immune checkpoint inhibitors Monoclonal antibodies Systemic cancer therapy includes chemotherapy (ie, conventional or cytotoxic chemotherapy), hormone therapy, targeted therapy, and immune therapy (see also Overview of Cancer Therapy). The number... read more , have an increased risk for development of autoimmune disorders Autoimmune Disorders In autoimmune disorders, the immune system produces antibodies to an endogenous antigen (autoantigen). The following hypersensitivity reactions may be involved: Type II: Antibody-coated cells... read more , including endocrine disorders. Hypophysitis, autoimmune thyroid disease (both hyperthyroidism Hyperthyroidism Hyperthyroidism is characterized by hypermetabolism and elevated serum levels of free thyroid hormones. Symptoms are many and include tachycardia, fatigue, weight loss, nervousness, and tremor... read more Hyperthyroidism and hypothyroidism Hypothyroidism Hypothyroidism is thyroid hormone deficiency. It is diagnosed by clinical features such as a typical facial appearance, hoarse slow speech, and dry skin and by low levels of thyroid hormones... read more Hypothyroidism ), type 1 diabetes Diabetes Mellitus (DM) Diabetes mellitus is impaired insulin secretion and variable degrees of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia... read more , and primary adrenal insufficiency Addison Disease Addison disease is an insidious, usually progressive hypofunctioning of the adrenal cortex. It causes various symptoms, including hypotension and hyperpigmentation, and can lead to adrenal crisis... read more Addison Disease have been reported (1, 2 General references Patients receiving drugs in the novel class of cancer therapeutics called immune checkpoint inhibitors, have an increased risk for development of autoimmune disorders, including endocrine disorders... read more ).

Diagnosis is by measurement of levels of glucose, electrolytes, and hormones as clinically indicated.

Treatment is replacement of hormones documented to be deficient. These might include thyroid hormone, insulin, or glucocorticoids.

General references

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Secondary Adrenal Insufficiency
Secondary adrenal insufficiency is adrenal hypofunction due to lack of adrenocorticotropic hormone (ACTH). Most of the symptoms and signs of this condition are similar to those of Addison disease. Which of the following symptoms and signs is present in patients with secondary adrenal insufficiency but not in patients with Addison disease?
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