Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2016) 41 EP288 | DOI: 10.1530/endoabs.41.EP288

ECE2016 Eposter Presentations Clinical case reports - Pituitary/Adrenal (81 abstracts)

Another case report of ipilimumab induced hypophysitis

Nawal Ibraheem

Queen’s Medical Centre, Nottingham, UK.

Introduction: We are presenting a case of presumed ipilimumab induced hypophysitis, after completion of 4th cycle of Ipilimumab for stage 4 melanoma.

Case Report: A 72-year-old gentleman diagnosed with stage 4 melanoma, Presented with generalised joint pain and fatigue after 4th cycle of ipilimumab, he had short synacthen test, baseline serum cortisol was <30 nmol/l, 30 min cortisol 379 nmol/l, he was started hydrocortisone therapy 10 mg in the morning, 5 mg at lunch, 5 mg in the evening.

His thyroid function at that time showed TSH <0.1 mU/l, with free T4 of 10.7 pmol/l, and a free T3 of 4.2 pmol/l. He had a normal prolactin, and low testosterone at 0.6 nmol/l. He underwent MRI of pituitary which showed normal appearance of pituitary gland, stalks and optic chiasm.

Discussion: Ipilimumab is a human monoclonal antibody that has been shown to overcome the suppressive effects of cytotoxic T lymphocyte Antigen 4 expression, thereby enhancing the immune response against tumours. It is used in the treatment of metastatic melanoma. Side effects include hypophysitis, colitis, uveitis, dermatitis and arthritis among others.

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