Loading...
Immune checkpoint inhibitor-mediated hypophysitis: no place like home
Cooksley, Timothy J Knight, Thomas Lindsay, Duncan Gupta, Avinash Ho, Jan Hoong Higham, Claire E Lorigan, Paul C Adam, Safwaan
Cooksley, Timothy J
Knight, Thomas
Lindsay, Duncan
Gupta, Avinash
Ho, Jan Hoong
Higham, Claire E
Lorigan, Paul C
Adam, Safwaan
Citations
Altmetric:
Abstract
Ambulatory emergency care forms a fundamental part of the strategy of trying to ensure safe and sustainable acute care services. Immune checkpoint inhibitor(ICI)-mediated hypophysitis is an important life-threatening complication of therapy. Patients presenting with clinical features and findings consistent with ICI-mediated hypophysitis were considered in the current study. In the absence of severe features (sodium <125 mmol/L, hypotension, reduced consciousness, hypoglycaemia and/or visual field defect), patients were administered a single intravenous dose of hydrocortisone (100 mg), observed for at least 4 h and then discharged on oral hydrocortisone (20 mg, 10 mg and 10 mg). Patients were then seen urgently in the endocrinology outpatient setting for further management. Fourteen patients (median age 64, 10 male) were managed using the pathway. All patients had biochemically confirmed adrenocorticotropic hormone (ACTH) deficiency. Seven of the 14 were treated with combination ICI therapy, with four having pan-anterior hypopituitarism. There were no 30-day readmissions or any associated hypophysitis-related mortality. All patients continued ICI therapy without interruption.
Affiliation
Description
Date
2023
Publisher
Collections
Files
Keywords
Type
Article
Citation
Cooksley T, Knight T, Lindsay D, Gupta A, Ho JH, Higham C, et al. Immune checkpoint inhibitor-mediated hypophysitis: no place like home. Clinical medicine (London, England). 2023 Jan;23(1):81-4. PubMed PMID: 36697002. Epub 2023/01/26. eng.