ArticleThe American journal of pathology2016
Hypophysitis Secondary to Cytotoxic T-Lymphocyte-Associated Protein 4 Blockade: Insights into Pathogenesis from an Autopsy Series.
Article in The American journal of pathology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 197 papers, 5 of them syntheses that pooled it.
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Who cites it
197 citing papers in PubMed, 5 syntheses or guidelines pooled it, 370 citations in OpenAlex.
- Outcomes of Initial Management Strategies in Patients With Autoimmune Lymphocytic Hypophysitis: A Systematic Review and Meta-analysis.The Journal of clinical endocrinology and metabolism · 2022Pooled it
- Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune checkpoint inhibitor endocrinopathies and the role of advanced practice providers in the management of immune-mediated toxicities.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Guideline
- Fatal Adverse Events Associated With Programmed Cell Death Ligand 1 Inhibitors: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2020Pooled it
- French Endocrine Society Guidance on endocrine side effects of immunotherapy.Endocrine-related cancer · 2019Guideline
- Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Meta-analysis.JAMA oncology · 2018Pooled it
- Delayed and multisystem immune-related adverse events in MSI-high colon cancer treated with nivolumab plus ipilimumab.Clinical journal of gastroenterology · 2026Article
- Secondary Adrenal Insufficiency and Multisystem Endocrinopathy Following Immune Checkpoint Inhibitor Therapy.Annals of African medicine · 2026Article
- Endocrine late-effects in survivors of childhood and adolescence cancer: clinical management.Journal of endocrinological investigation · 2026Review
- Article
- Review
- Immune-Mediated Hypophysitis: An Updated Review.Journal of clinical medicine · 2026Review
- Transient adrenocorticotropic hormone elevation with a disproportionate cortisol response prior to the onset of immune checkpoint inhibitor-related hypophysitis.Hormones (Athens, Greece) · 2026Review
- MLANA is a potential prognostic biomarker and correlated with immune infiltration in skin cutaneous melanoma.Clinical and experimental medicine · 2026Article
- Safety profile of ipilimumab in elderly patients: a disproportionate analysis based on the FDA Adverse Event Reporting System database.Frontiers in oncology · 2026Article
- Immune checkpoint inhibitor-related endocrinopathies: from immune crosstalk to predictive biomarkers and precision management.Frontiers in endocrinology · 2026Review
- Review
- Article
- The Pituitary Immune Environment and Immunotherapy: From Hypophysitis to Pituitary Neuroendocrine Tumors.Cells · 2025Review
- Autopsy rates and diagnostic errors in a Swiss community hospital: a ten-year retrospective analysis.Virchows Archiv : an international journal of pathology · 2025Article
- Review
137 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
Hypophysitis that develops in cancer patients treated with monoclonal antibodies blocking cytotoxic T-lymphocyte-associated protein 4 (CTLA-4; an inhibitory molecule classically expressed on T cells) is now reported at an incidence of approximately 10%. Its pathogenesis is unknown, in part because no pathologic examination of the pituitary gland has been reported to date. We analyzed at autopsy the pituitary glands of six cancer patients treated with CTLA-4 blockade, one with clinical and pathologic evidence of hypophysitis, one with mild lymphocytic infiltration in the pituitary gland but no clinical signs of hypophysitis, and four with normal pituitary structure and function. CTLA-4 antigen was expressed by pituitary endocrine cells in all patients but at different levels. The highest levels were found in the patient who had clinical and pathologic evidence of severe hypophysitis. This high pituitary CTLA-4 expression was associated with T-cell infiltration and IgG-dependent complement fixation and phagocytosis, immune reactions that induced an extensive destruction of the adenohypophyseal architecture. Pituitary CTLA-4 expression was confirmed in a validation group of 37 surgical pituitary adenomas and 11 normal pituitary glands. The study suggests that administration of CTLA-4 blocking antibodies to patients who express high levels of CTLA-4 antigen in the pituitary can cause an aggressive (necrotizing) form of hypophysitis through type IV (T-cell dependent) and type II (IgG dependent) immune mechanisms.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.