Alemtuzumab – Thyroid Autoimmunity — SCE Neurology MCQ
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Correct answer: C — Graves disease secondary to alemtuzumab-induced autoimmunity
Alemtuzumab-induced thyroid autoimmunity is the most common secondary autoimmune complication, occurring in approximately 40% of treated patients. Graves disease (with TSH receptor antibodies) is the most frequent thyroid disorder, though Hashimoto thyroiditis also occurs. Monthly thyroid function monitoring is mandatory for at least 48 months after the last alemtuzumab dose. Treatment is standard for Graves disease (carbimazole, radioiodine, or surgery). A: This is the most likely cause given the timing. B: Hashimoto causes hypothyroidism, not thyrotoxicosis. C: Thyroid storm is a complication of untreated hyperthyroidism. D: Subacute thyroiditis is post-viral. E: Pituitary adenoma would cause elevated TSH.
Reference: NICE TA312 Alemtuzumab (2014); Alemtuzumab SmPC