ArticleJournal for immunotherapy of cancer2019
Inflammation-induced hypoparathyroidism triggered by combination immune checkpoint blockade for melanoma.
Article in Journal for immunotherapy of cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition: an ESE clinical practice guideline.European journal of endocrinology · 2022Guideline
- Bone Adverse Events in Cancer Patients Undergoing Immune Checkpoint Inhibitor Therapy: A Comprehensive Review of the Literature from the Clinical Action Group of the European Calcified Tissue Society.Calcified tissue international · 2026Review
- Immune checkpoint inhibitors associated thyroiditis: mechanisms and clinical outcomes.Journal of endocrinological investigation · 2025Review
- Hypoparathyroidism induced by immune checkpoint inhibitors: a review of literature reports and real-world pharmacovigilance data.Endocrine connections · 2025Article
- An Extremely Rare Case of Immune Checkpoint Inhibitors-Related Hypoparathyroidism and a Critical Literature Review.JCEM case reports · 2025Article
- Management, biomarkers and prognosis in people developing endocrinopathies associated with immune checkpoint inhibitors.Nature reviews. Endocrinology · 2025Review
- Case Report: Accelerated parathyroid adenoma progression and hypercalcemia-driven neurotoxicity following pembrolizumab-based neoadjuvant therapy in triple-negative breast cancer: a case of multisystem immune-related adverse events.Frontiers in oncology · 2025Article
- Life-Threatening Endocrinological Immune-Related Adverse Events of Immune Checkpoint Inhibitor Therapy.Cancers · 2023Review
- Inflammatory and Infectious Disorders in Endocrine Pathology.Endocrine pathology · 2023Review
- Article
- Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer.Endocrine connections · 2023Review
- Review
- Review
- Immune-Related Uncommon Adverse Events in Patients with Cancer Treated with Immunotherapy.Diagnostics (Basel, Switzerland) · 2022Review
- The calcium-sensing receptor in inflammation: Recent updates.Frontiers in physiology · 2022Review
- Hypoparathyroidism: an uncommon adverse effect of treatment with durvalumab.Endocrine oncology (Bristol, England) · 2022Article
- Endocrine toxicities of immune checkpoint inhibitors.Nature reviews. Endocrinology · 2021Review
- Organ-specific Adverse Events of Immune Checkpoint Inhibitor Therapy, with Special Reference to Endocrinopathies.TouchREVIEWS in endocrinology · 2021Review
- Clinical Characteristics, Management, and Potential Biomarkers of Endocrine Dysfunction Induced by Immune Checkpoint Inhibitors.Endocrinology and metabolism (Seoul, Korea) · 2021Review
- Endocrine complications of immunotherapies: a review.Clinical medicine (London, England) · 2021Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment with a combination of PD-1 and CTLA-4 targeted checkpoint inhibition has improved outcome of melanoma patients and led to durable remissions but is also associated with significant toxicities. Endocrinopathies such as thyroiditis and hypophysitis are often seen, but other, rarer disturbances have also been described. Endocrinopathies affecting the parathyroid gland are rarely reported and no clear pathomechanism has been proposed. CASE PRESENTATION: Here, we report a case of severe hypocalcemia due to an antibody-mediated hypoparathyroidism as an immune-related adverse event (irAE) in a patient who was treated with the anti-PD-1 antibody nivolumab and anti-CTLA-4 antibody ipilimumab. Hypocalcemia was rapidly corrected by substitution, but the endogenous serum parathyroid hormone (PTH) remained low. The patient demonstrated a rapid and profound tumor response to the combination immune checkpoint blockade, but developed a severe colitis that required high-dose intravenous corticosteroid and anti-TNFα therapy. During this strong immunosuppression the PTH level normalized and the calcium levels were stable without substitution. However, during tapering of immunosuppressants, the PTH and calcium levels decreased again to a level requiring calcium substitution.
conclusionOur report demonstrates a rare endocrinopathy as a complication of combined PD-1 and CTLA-4 blockade. In addition, it provides evidence from the course of the disease that inflammation within the parathyroid gland is involved in the mechanism.
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