Isolated Adrenocorticotropin Deficiency due to Nivolumab-induced Hypophysitis in a Patient with Advanced Lung Adenocarcinoma: A Case Report and Literature Review
Open Access
- 1 January 2018
- journal article
- review article
- Published by Japanese Society of Internal Medicine in Internal Medicine
- Vol. 57 (4), 527-535
- https://doi.org/10.2169/internalmedicine.9074-17
Abstract
A 63-year-old Japanese woman with advanced lung adenocarcinoma developed isolated adrenocorticotropin deficiency caused by immune checkpoint inhibitor (ICI)-related hypophysitis following 8 months of nivolumab therapy. Prompt corticosteroid replacement therapy effectively relieved her secondary adrenal insufficiency symptoms and allowed her to pursue nivolumab therapy, which had been effective for the control of lung adenocarcinoma. Human leukocyte antigen (HLA) typing revealed the presence of the DRB1*04:05-DQA1*03:03-DQB1*04:01 haplotype, which is associated with susceptibility to autoimmune polyglandular syndrome with pituitary disorder in the Japanese population. This case suggests that genetic factors, such as HLA, contribute to the development of endocrinopathies induced by ICIs.Keywords
This publication has 34 references indexed in Scilit:
- Recommendations for clinical staging (cTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manualsDiseases of the Esophagus, 2016
- Fulminant type I diabetes mellitus associated with nivolumab in a patient with relapsed classical Hodgkin lymphomaInternational Journal of Hematology, 2016
- Endocrinological side-effects of immune checkpoint inhibitorsCurrent Opinion in Oncology, 2016
- Diagnosis, monitoring and management of immune-related adverse drug reactions of anti-PD-1 antibody therapyCancer Treatment Reviews, 2016
- The Evolving Role of Immune Checkpoint Inhibitors in Cancer TreatmentThe Oncologist, 2015
- Long-term follow-up of ipilimumab-induced hypophysitis, a common adverse event of the anti-CTLA-4 antibody in melanomaActa Endocrinologica, 2015
- Pituitary Expression of CTLA-4 Mediates Hypophysitis Secondary to Administration of CTLA-4 Blocking AntibodyScience Translational Medicine, 2014
- Diagnostic Usefulness of the Growth Hormone-Releasing Peptide-2 Test as a Substitute for the Insulin Tolerance Test in HypopituitarismEndocrine Journal, 2008
- Susceptibility Alleles and Haplotypes of Human Leukocyte Antigen DRB1, DQA1, and DQB1 in Autoimmune Polyglandular Syndrome Type III in Japanese PopulationHormone Research in Paediatrics, 2005
- Thyroid Dysfunction in isolated Adrenocorticotropic Hormone (ACTH) Deficiency: Case Report and Literature Review.Endocrine Journal, 1993