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Ipilimumab treatment associated pituitary hypophysitis: clinical presentation and imaging diagnosis.

Abstract：

:Ipilimumab is an immunomodulating drug for use in treatment of unresectable or metastatic melanoma with autoimmune lymphocytic hypophysitis as a reported complication. We describe three recent cases of ipilimumab associated autoimmune hypophysitis (IAH) at our institution, and provide a selected literature review showing its variable clinical presentation, imaging appearance and treatment in order to expedite early and appropriate IAH management. Patients had variable clinical presentation of hypophysitis, including headache, fatigue, visual changes, endocrinopathy, and/or hyponatremia. Contrast enhanced MRI showed symmetric pituitary gland and stalk enlargement in all of our cases and received a presumptive diagnosis of IAH. Following cessation of therapy and treatment there was normalization of pituitary morphology at follow-up MRI and return to clinical baseline. Varying clinical presentation can complicate the diagnosis of lymphocytic hypophysitis. One must be cognizant of its overall clinical and radiologic picture in patients receiving ipilimumab, now commonly used for the treatment of metastatic melanoma.

journal_name

Clin Neurol Neurosurg

journal_title

Clinical neurology and neurosurgery

authors

Chodakiewitz Y,Brown S,Boxerman JL,Brody JM,Rogg JM

doi

10.1016/j.clineuro.2014.06.011

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

125-30

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(14)00215-7

journal_volume

125

pub_type

杂志文章,评审

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