Reactions 1680, p190 - 2 Dec 2017 Autoimmune hypophysitis and hypoadrenocorticism: case report A 57-year-old woman developed autoimmune hypophysitis and hypoadrenocorticism following treatment with ipilimumab and nivolumab [routes not stated; not all time to reactions onsets stated]. The woman presented to the hospital with multiple metastatic melanoma lesions in the gastric wall, which were identified with endoscopy. She had a history of right uveal melanoma. At the first presentation, a CT scan demonstrated multiple metastatic lesions in the lungs and peritoneum. She was initiated on nivolumab 2 mg/kg per dose once every 3 weeks. However, another CT scan revealed progressive disease after six doses. Hence, four weeks after the last dose of nivolumab, she was initiated on ipilimumab 3 mg/kg per dose once every 3 weeks. She complained of fatigue, fever, muscle weakness and loss of appetite after two doses of nivolumab. Blood tests and head MRI revealed hypoadrenocorticism due to hypophysitis; assessed as treatment-related. The woman’s treatment with ipilimumab was discontinued and she received treatment with hydrocortisone. Subsequently, her symptoms improved. A month after the onset of hypoadrenocorticism, head MRI revealed no evidence of hypophysitis. Her hypoadrenocorticism was also successfully controlled by the hydrocortisone. Author comment: "At this point, blood tests and magnetic resonance imaging (MRI) of the head detected hypoadrenocorticism due to hypophysitis, which was assessed as being treatment-related." Ohnuma T, et al. Case of metastatic uveal melanoma in which an antitumor effect appeared after ipilimumab discontinuation due to autoimmune hypophysitis. Journal of Dermatology 44: 1325-1326, No. 11, Nov 2017. Available from: URL: http://doi.org/10.1111/1346-8138.13692 - Japan 803285511 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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