Thyroiditis: A Rare Manifestation of Enasidenib-Induced Differentiation Syndrome

Pavan Annamaraju; Swathi Gopishetty; Naga Goparaju; Matthew Beasey; Vamsi Kota; Achuta K Guddati

doi:10.1159/000507613

Thyroiditis: A Rare Manifestation of Enasidenib-Induced Differentiation Syndrome

Case Rep Oncol. 2020 May 27;13(2):583-587. doi: 10.1159/000507613. eCollection 2020 May-Aug.

Authors

Pavan Annamaraju¹, Swathi Gopishetty², Naga Goparaju¹, Matthew Beasey¹, Vamsi Kota³, Achuta K Guddati³

Affiliations

¹ Johnston Memorial Hospital, Ballad Health System, Abingdon, Virginia, USA.
² Medical Center of Central Georgia, Mercer University, Macon, Georgia, USA.
³ Division of Hematology/Oncology, Georgia Cancer Center, Augusta University, Augusta, Georgia, USA.

Abstract

Enasidenib is an FDA-approved isocitrate dehydrogenase 2 (IDH2) inhibitor, which is used in the treatment of acute myeloid leukemia (AML). We present a case of AML with an IDH2 mutation treated with a regimen of enasidenib and 5-azacitidine, where thyroiditis was noted to be a part of differentiation syndrome. The patient is a 77-year-old woman with IDH2-mutated AML who had initially been started on 100 mg of enasidenib and then presented with dyspnea and was diagnosed with pleural effusion - a common presentation with enasidenib - but was also noted to have thyroiditis. She was started on steroids, but due to continued hyperbilirubinemia and thyroiditis, her dose of enasidenib was reduced to half, which resulted in clinical improvement. This case demonstrates thyroiditis as one of the rare manifestations in the treatment of AML with enasidenib-induced differentiation syndrome.

Keywords: Acute myeloid leukemia; Chemotherapy; Drug therapy; Enasidenib.

Publication types

Case Reports