ArticleIn vivo (Athens, Greece)
Thyrotoxicosis and Adrenocortical Hormone Deficiency During Immune-checkpoint Inhibitor Treatment for Malignant Melanoma.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Immune checkpoint inhibitor-induced isolated adrenocorticotropic hormone deficiency: a systematic review.Frontiers in endocrinology · 2024Pooled it
- Pooled it
- PD-1/PD-L1 inhibitor-induced hyponatremia: a real-world pharmacovigilance analysis using FAERS database.Frontiers in immunology · 2025Article
- Improved overall survival in patients developing endocrine toxicity during treatment with nivolumab for advanced non-small cell lung cancer in a prospective study.Journal of endocrinological investigation · 2024Article
- Secondary adrenocortical insufficiency after treatment with retifanlimab: a case report.Frontiers in immunology · 2024Article
- Isolated Adrenocorticotropic Hormone Deficiency Associated with Severe Hyperkalemia During Pembrolizumab Therapy in a Patient with Ureteral Cancer and an Ileal Conduit: A Case Report and Literature Review.The American journal of case reports · 2021Review
- Immune checkpoint inhibitors-induced eosinophilic pneumonia: A case report.Thoracic cancer · 2021Article
- Fast Independent Component Analysis Algorithm-Based Diagnosis of L5 Nerve Root Compression and Changes of Brain Functional Areas Using 3D Functional Magnetic Resonance Imaging.Journal of healthcare engineering · 2021Article
- Predictive and sensitive biomarkers for thyroid dysfunctions during treatment with immune-checkpoint inhibitors.Cancer science · 2020Article
- Adverse Effects of Immune Checkpoint Inhibitors (Programmed Death-1 Inhibitors and Cytotoxic T-Lymphocyte-Associated Protein-4 Inhibitors): Results of a Retrospective Study.Journal of clinical medicine research · 2019Review
- Isolated adrenocorticotropic hormone deficiency and thyroiditis associated with nivolumab therapy in a patient with advanced lung adenocarcinoma: a case report and review of the literature.Journal of medical case reports · 2019Review
- Immune-Related Adverse Events From Immunotherapy: Incorporating Care Step Pathways to Improve Management Across Tumor Types.Journal of the advanced practitioner in oncology · 2019Review
- Post-immunotherapy new onset diabetes (PINOD)-under-recognized etiology, unexplored presentation.Annals of translational medicine · 2018Article
- Follow-up Care for Patients Receiving Immune Checkpoint Inhibitors.Asia-Pacific journal of oncology nursingReview
- Hypothyroidism With ACTH Deficiency During Pembrolizumab Therapy for Lung Cancer: Case Report and Literature Review.Cancer diagnosis & prognosisArticle
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmune-checkpoint inhibitors (ICIs) are novel promising agents for the treatment of malignant tumors. However, critical endocrine immune-related adverse events (irAEs) by ICIs often occur. CASE REPORT: A 63-year-old woman with advanced malignant melanoma had received anti-PD-1 antibody (nivolumab, 2 mg/kg every 3 weeks) for 8 cycles (from day 0 to day 147). On day 168, nivolumab was switched to anti-CTLA-4 antibody (ipilimumab, 3mg/kg every 3 weeks). Twenty-eight days later, she was diagnosed with thyrotoxicosis due to painless thyroiditis (day 196). Thirty-five days later (day 231), thyrotoxicosis turned to hypothyroidism. In addition, twenty-five days later (day 256), she was diagnosed with adrenocortical insufficiency due to adrenocortical hormone (ACTH) deficiency. Hormone replacements with levothyroxine and hydrocortisone were administered. She showed eosinophilia, ESR/CRP/LDH elevation, liver dysfunction and hyponatremia before diagnosis of ACTH insufficiency. Eosinophilia, thrombocytopenia, ESR/CRP/LDH elevation, and liver dysfunction might be important for early detection of thyrotoxicosis in our case.
conclusionThe present report provides the first detailed presentation of combined thyrotoxicosis and isolated ACTH deficiency induced by ICIs. Since rapidly progressive fatal endocrine system failure may be provoked during ICI therapy, precise diagnosis and prompt treatment as well as close follow-up is critical. We propose routine monitoring of endocrine functions and related symptoms (worsened fatigue, hypoglycemia, hypotension or hyponatremia), as well as other laboratory tests during ICI therapy.
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