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(a) Thyroiditis: hyperthyroid phase followed by hypothyroid phase in a patient treated with pembrolizumab. (b) Hyperthyroidism generally occurred within 3-6 weeks of initiation of pembrolizumab therapy (time = 0). Hypothyroid phase was evident by week 9 of pembrolizumab therapy and was characterised by markedly elevated TSH levels.
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Thyroiditis was characterised by a brief asymptomatic hyperthyroid phase followed by a symptomatic hypothyroid phase (Figure 3(a)) requiring thyroxine replacement. In most cases, the hypothyroid phase was evident by week 9 of pembrolizumab therapy and was characterised by markedly elevated TSH levels (Figure 3(b)).
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