• Ensure that patient undergoes thyroid function tests prior to first dose, every 12 weeks while on PD-1 therapy and q3 weeks with ipilimumab
  • High TSH with low free T4 consistent with primary hypothyroidism
  • DDX: secondary hypothyroidism due to hypophysitis, low TSH and low free T4
  • Occasionally thyroiditis with transient hyperthyroidism (low TSH and high free T4) may be followed by more longstanding hypothyroidism (high TSH and low free T4)
  • Other immune-related toxicity?
  • Prior thyroid dysfunction?
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