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FIGURE LEGEND
Fig 1. Clinical course of the case
TSH and fT4 were within the normal range during recombinant human EPO administration. After starting roxadustat, his TSH and fT4 gradually decreased to 0.47μIU/mL and 0.15 ng/dL, respectively. After administration of 200 μg of levothyroxine, fT4 recovered quickly into the normal range, but TSH did not recover. In January 2023, roxadustat was switched to daprodustat. After discontinuing roxadustat, TSH recovered rapidly into the normal range and and cholesterol levels increased to their original levels.