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Hypothyroidism in patients with multiple myeloma following treatment with thalidomide

      Thalidomide is used for the management of several diseases, including the treatment of patients with multiple myeloma who have relapsed(
      • Singhal S.
      • Mehta J.
      • Desikan R.
      • et al.
      Antitumor activity of thalidomide in refractory multiple myeloma.
      ,
      • Blade J.
      • Esteve J.
      Treatment approaches for relapsing and refractory multiple myeloma.
      ,
      • Barlogie B.
      • Desikan R.
      • Eddlemon P.
      • et al.
      Extended survival in advanced and refractory multiple myeloma after single-agent thalidomide identification of prognostic factors in a phase 2 study of 169 patients.
      ). As the number of patients receiving thalidomide for longer periods of time increases, several previously unrecognized adverse events have been observed (
      • Rajkumar S.V.
      • Gertz M.A.
      • Witzig T.E.
      Life-threatening toxic epidermal necrolysis with thalidomide therapy for myeloma.
      ,
      • Williams I.
      • Weller I.V.
      • Malni A.
      • et al.
      Thalidomide hypersensitivity in AIDS.
      ,
      • Zangari M.
      • Anaissie E.
      • Barlogie B.
      • et al.
      Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy.
      ). We observed symptomatic hypothyroidism, characterized by a high serum thyroid-stimulating hormone (TSH) level and low thyroxine level, in a patient with multiple myeloma during therapy with thalidomide. Indeed, known adverse effects of thalidomide, such as bradycardia, lethargy, and constipation, are potential manifestation of hypothyroidism. This led us to evaluate thyroid function tests, when available, in multiple myeloma patients who had received thalidomide in our clinical trials.

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