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.
"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
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved