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Medicine Matters oncology

Features: Tachycardia, excessive sweating, palpitations, tremor, diarrhea, weight loss, anxiety, irritability, periorbital pain, headaches, and insomnia.

Investigations: TFTs including FT3 and FT4, should be obtained. HCPs should consider checking anti-TSH antibodies.

Management: Management of hyperthyroidism mostly depends on the patients’ symptoms, with which ICI treatment can normally be continued despite thyroid dysfunction. Supportive measures such as beta-blockers can help to manage symptoms such as tachycardia, palpitations, and tremor. Steroids can be helpful and should be initiated if the patient is very symptomatic. The use of carbimazole is limited due to lack of evidence and is only normally considered in syndromes resembling Grave’s disease [6].  Where there is a clinical indication of Graves’ ophthalmology, case studies have discussed the importance of diagnostic imaging to assess the extent of swelling in the extraocular muscles [4].