Late-onset hypophysitis after discontinuation of nivolumab treatment for advanced skin melanoma: a case report.
Late-onset hypophysitis after discontinuation of nivolumab treatment for advanced skin melanoma: a case report.
复制标题
DOI：
10.1186/s12902-021-00854-y
复制
发表时间：
2021-09-20
影响因子：
2.7
通讯作者：
Berg C
中科院分区：
文献类型：
--
作者：
Antoniou S;Bazazo G;Röckl L;Papadakis M;Berg C
Nivolumab是一种抗程序性细胞死亡蛋白1抗体，通常用作癌症免疫治疗剂。尽管有多种临床益处，但它可能会引起与自身免疫相关的副作用，通常涉及内分泌系统。据我们所知，这是第一例尼伏鲁单抗引起的垂体炎，在停止治疗几个月后表现出来。我们在此报告一位53岁的患者，患有垂体炎和孤立性促肾上腺皮质激素缺乏，表现为反复发作的突触发作和持续性的轻度低钠血症。所进行的挑战测试符合继发性肾上腺功能不全，而其他垂体前叶激素的反应被保留下来。磁共振成像显示脑垂体柄增厚，与垂体炎相符。在使用氢化可的松后，患者的病情逐渐好转，钠和血糖水平恢复正常。并对相关文献进行了讨论。我们的结论是，即使在停止使用nivolumab后，也可能发生孤立的肾上腺功能不全。因此，在使用此类药物的情况下，需要进行临床评估，并常规监测血压、钠、血糖水平、垂体激素以及磁共振成像，以确定这种情况并防止肾上腺危象的发生。
Nivolumab is an anti-programmed cell death protein 1 antibody, typically used as cancer immunotherapy agent. Despite multiple clinical benefits it might cause autoimmune-related side-effects, often involving the endocrine system. To our knowledge, this is the first case of nivolumab-induced hypophysitis manifesting several months after treatment discontinuation. We, herein, report a 53-year-old patient with hypophysitis and isolated adrenocorticotropic hormone deficiency, who presented with recurring syncopal episodes and persistent mild hyponatremia. The performed challenged tests were consistent with secondary adrenal insufficiency, while responses of other anterior pituitary hormones were preserved. Magnetic resonance imaging revealed thickened pituitary stalk, consistent with hypophysitis. The patient’s condition gradually improved after administration of hydrocortisone, with normalization of sodium and glucose-levels. The related literature is discussed. We conclude that even after discontinuation of nivolumab, isolated adrenal insufficiency can occur. Therefore, in case of administration of such agents, clinical assessment, and routine monitoring of blood pressure, sodium-, glucose-levels, pituitary hormones as well as magnetic resonance imaging are needed to identify such conditions and prevent an adrenal crisis.
登录
查看更多内容
PD-1和PD-L1抑制剂作为癌症免疫疗法的一种形式的开发：对注册试验和未来考虑的全面综述。
影响因子：
10.9
作者：
Gong J;Chehrazi-Raffle A;Reddi S;Salgia R
通讯作者：
Salgia R
影响因子：
3.5
作者：
Carpenter, K. J.;Murtagh, R. D.;Murtagh, F. R.
通讯作者：
Murtagh, F. R.
影响因子：
5.8
作者：
Leporati, Paola;Landek-Salgado, Melissa A.;Caturegli, Patrizio
通讯作者：
Caturegli, Patrizio
DOI：
10.1097/00042737-200606000-00019
发表时间：
2006-06-01
影响因子：
2.1
作者：
Ridruejo, Ezequiel;Christensen, Alejo Florin;Mando, Oscar G.
通讯作者：
Mando, Oscar G.
影响因子：
5.8
作者：
Turcu, Adina F.;Erickson, Bradley J.;Young, William F., Jr.
通讯作者：
Young, William F., Jr.