{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T02:59:54Z","timestamp":1719975594347},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          Inzidenzen endokriner Nebenwirkungen von Immuncheckpoint-Inhibitoren\u2002Je nach Klasse der Immuncheckpoint-Inhibitoren (ICI) unterscheidet sich die H\u00e4ufigkeit endokriner Nebenwirkungen. Eine Inhibition des PD-1 (programmed cell death receptor 1) oder seines Liganden PD-L1 f\u00fchrt h\u00e4ufig zu einer Thyreoiditis, eine Immunkombinationstherapie mit\u00a0CTLA-4-Antagonisten (cytotoxic T lymphocyte antigen 4) besonders h\u00e4ufig zur Hypophysitis.<\/jats:p><jats:p>\n          Hypophysitis\u2002Eine Hypophysitis ist eine potenziell lebensbedrohliche Komplikation, ma\u00dfgeblich aufgrund der dadurch bedingten sekund\u00e4ren Nebenniereninsuffizienz. Sie geht oft mit passageren Kopfschmerzen einher, dar\u00fcber hinaus bestehen h\u00e4ufig unspezifische Symptome wie Abgeschlagenheit und Schwindel. Die Bildgebung der Sella verl\u00e4uft mitunter unspezifisch. Laborchemisch imponiert meist eine Hyponatri\u00e4mie. Der Verdacht erfordert die umgehende Substitution von Glukokortikoiden, die bei drohender oder manifester Nebennierenkrise intraven\u00f6s erfolgen muss. Weitere beeintr\u00e4chtigte Hypophysenachsen werden im Verlauf (\u00fcblicherweise dauerhaft) substituiert.<\/jats:p><jats:p>\n          Schilddr\u00fcsenfunktionsst\u00f6rungen\u2002Ursache ist h\u00e4ufig die immunvermittelte Destruktion des Schilddr\u00fcsenparenchyms, die in der Regel zu einer transienten Hyperthyreose gefolgt von einer Hypothyreose f\u00fchrt. In der hyperthyreoten Phase ist oft keine spezifische Therapie erforderlich, die Hypothyreose muss \u2013 in der Regel fortw\u00e4hrend \u2013 substituiert werden. Seltene und potenziell lebensbedrohliche weitere immunvermittelte Nebenwirkungen endokriner Organe sind prim\u00e4re Nebenniereninsuffizienz, Diabetes mellitus Typ I und Hypoparathyreoidismus.<\/jats:p><jats:p>\n          Auswirkung auf die Prognose der Tumorerkrankung Auch nach endokrinen immunvermittelten Nebenwirkungen (irAE) und Substitutionstherapie sollte die Fortsetzung der ICI-Therapie erwogen werden. Entscheidende Schritte zur Fr\u00fcherkennung endokriner Nebenwirkungen von ICI sind die Aufkl\u00e4rung des Patienten, regelm\u00e4\u00dfige Laborkontrollen (Hormone, Elektrolyte) vor bzw. w\u00e4hrend einer Immuntherapie und das \u201eDrandenken\u201c, selbst wenn eine Immuntherapie bereits l\u00e4ngere Zeit zur\u00fcckliegt.<\/jats:p>","DOI":"10.1055\/a-1140-2920","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T23:48:40Z","timestamp":1606780120000},"page":"1736-1741","source":"Crossref","is-referenced-by-count":0,"title":["Endokrine Nebenwirkungen onkologischer Immuntherapien"],"prefix":"10.1055","volume":"145","author":[{"given":"Matthias","family":"Kroi\u00df","sequence":"additional","affiliation":[{"name":"Schwerpunkt Endokrinologie\/Diabetologie, Medizinische Klinik und Poliklinik I, Universit\u00e4tsklinikum W\u00fcrzburg"},{"name":"Comprehensive Cancer Center Mainfranken, Universit\u00e4t W\u00fcrzburg"},{"name":"Medizinische Klinik und Poliklinik IV, LMU Klinikum der\u00a0Universit\u00e4t M\u00fcnchen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Schilling","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center Mainfranken, Universit\u00e4t W\u00fcrzburg"},{"name":"Klinik und Poliklinik f\u00fcr Haut- und Geschlechtskrankheiten, Universit\u00e4tsklinikum W\u00fcrzburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[{"name":"Schwerpunkt Endokrinologie\/Diabetologie, Medizinische Klinik und Poliklinik I, Universit\u00e4tsklinikum W\u00fcrzburg"},{"name":"Medicover Oldenburg MVZ"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"ref1","first-page":"119","article-title":"Checkpoint Inhibitors","volume":"116","author":"L Heinzerling","year":"2019","journal-title":"Dtsch \u00c4rztebl 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