{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:22:51Z","timestamp":1777875771926,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2020,7]]},"abstract":"\n Background:<\/jats:title>\n Immune checkpoint inhibitors (ICIs) are associated with several endocrine side effects. In particular, the use of programmed cell death protein-1 (PD-1)\/programmed cell death-ligand 1 (PD-L1) inhibitors is related to a higher incidence of thyroid dysfunction.<\/jats:p>\n <\/jats:sec>\n \n Patient Findings:<\/jats:title>\n An 85 years-old patient, diagnosed with a metastatic melanoma treated with nivolumab, presented to our hospital with severe ICI-related thyrotoxicosis. Diagnosis was complicated by a biochemical interference on thyroid hormones assay, probably induced by nivolumab.<\/jats:p>\n <\/jats:sec>\n \n Summary:<\/jats:title>\n \n Baseline laboratory examination conducted before onset of anticancer therapy showed normal thyroid function test (TFTs). A few days after receiving the second nivolumab administration, the patient developed a severe thyrotoxicosis. According to destructive thyroiditis, in a short period thyrotropin (TSH) levels normalized and rapidly increased, but free thyroxine (fT4) levels were inappropriately elevated and did not decrease as expected. The sample was processed by using a Siemens Centaur\n \u00ae<\/jats:sup>\n immunoassay. We reanalyzed the same sample at another laboratory and with a different immunoassay method (Roche Elecsys\n \u00ae<\/jats:sup>\n ). The results obtained from this assay confirmed severe hypothyroidism with appropriately low fT4 levels. We suspected a possible nivolumab-associated interference on the fT4 assay. Therefore, we subjected the same sample to a polyethylene glycol (PEG) 6000 precipitation, a simple method for the removal of macromolecules, before assaying for fT4 levels. Evaluation of the post-PEG-precipitation sample (Siemens Centaur immunoassay) revealed appropriately low fT4 levels. The patient was started on levothyroxine (LT4) therapy, with monthly TFT monitoring using the Roche immunoassay. Approximately 9 months after starting nivolumab therapy, the patient was advised treatment cessation. A month later, the TFTs were retested on a Siemens Centaur immunoassay, and appropriate fT4 levels were observed in accordance with normal TSH levels on adequate LT4 replacement therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n We report a possible novel nivolumab-induced biochemical interference on assays of fT4 levels. The hypothesis of a biochemical drug-induced interference is further supported by the disappearance of the interference after the withdrawal of nivolumab. Further studies are needed to prove the biochemical mechanisms of this interference.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/thy.2019.0799","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T02:12:08Z","timestamp":1583201528000},"page":"1091-1094","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Immunoassay Interference on Thyroid Function Tests During Treatment with Nivolumab"],"prefix":"10.1177","volume":"30","author":[{"given":"Rosa Maria","family":"Paragliola","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Corsello","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampaolo","family":"Papi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Melfa","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Clinical Biochemistry, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Urbani","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Clinical Biochemistry, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Pontecorvi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore Maria","family":"Corsello","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinzia","family":"Carrozza","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Clinical Biochemistry, Universit\u00e0 Cattolica del Sacro Cuore\u2014Fondazione Policlinico \u201cGemelli\u201d IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000293"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-0843-3366"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000501824"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00119"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.med.0000137759.57791.f8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3747\/co.23.3026"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2007.099770"}],"container-title":["Thyroid\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/thy.2019.0799","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2019.0799","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2019.0799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:06:58Z","timestamp":1777586818000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/thy.2019.0799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1089\/thy.2019.0799"],"URL":"https:\/\/doi.org\/10.1089\/thy.2019.0799","relation":{},"ISSN":["1050-7256","1557-9077"],"issn-type":[{"value":"1050-7256","type":"print"},{"value":"1557-9077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]}}}