{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:06:20Z","timestamp":1775570780945,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Apalutamide (APA) is an androgen receptor signaling inhibitor widely used for metastatic hormone\u2010sensitive prostate cancer (mHSPC), though it can induce hypothyroidism. We report a severe case of APA\u2010induced hypothyroidism in a patient with a history of total thyroidectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 65\u2010year\u2010old man receiving levothyroxine (175\u2009\u03bcg\/day) after thyroidectomy was diagnosed with mHSPC (Gleason score 4\u2009+\u20094; PSA 13\u2009904\u2009ng\/mL) with findings suggestive of cancer\u2010associated disseminated intravascular coagulation. Following APA initiation (240\u2009mg\/day), PSA decreased rapidly to 0.01\u2009ng\/mL. However, TSH levels rose progressively despite increasing levothyroxine to 275\u2009\u03bcg\/day. After a 4\u2010month follow\u2010up interruption, TSH reached 187.9\u2009mIU\/L. APA withdrawal led to rapid TSH improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Careful TSH monitoring is essential during APA treatment, especially in patients with pre\u2010existing thyroid dysfunction or prior thyroidectomy. Appropriate levothyroxine titration and multidisciplinary collaboration are essential for the continuation of oncological therapy with APA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70161","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:46:26Z","timestamp":1773017186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Apalutamide\u2010Induced Hypothyroidism Associated With Increased Thyroid Hormone Clearance in Metastatic Prostate Cancer Patient: A Case Report"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-6529","authenticated-orcid":false,"given":"Jun","family":"Furumido","sequence":"first","affiliation":[{"name":"Department of Urology Asahikawa Kosei General Hospital  Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Urology Asahikawa Kosei General Hospital  Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Urology Asahikawa Kosei General Hospital  Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanta","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Urology Asahikawa Kosei General Hospital  Hokkaido Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209096"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405095"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1715546"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903307"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14447"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/toxsci\/kfq125"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-25-0185"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.230555"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvae105"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-24-0158"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0028"}],"container-title":["IJU Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iju5.70161","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/iju5.70161","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/iju5.70161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:21:46Z","timestamp":1774574506000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/iju5.70161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/iju5.70161"],"URL":"https:\/\/doi.org\/10.1002\/iju5.70161","archive":["Portico"],"relation":{},"ISSN":["2577-171X","2577-171X"],"issn-type":[{"value":"2577-171X","type":"print"},{"value":"2577-171X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70161"}}