1. Pituitary Gland
Thyrotoxicosis
Adrenal Gland
Thyroid/Parathyroid
Bone Health
Skin + Heart
$100
$100
$100
$100
$100
$200
$200
$200
$200
$200
$300
$300
$300
$300
$300
$400
$400
$400
$400
$400
$500
$500
$500
$500
$500

2. Pituitary $500-64 year-old male being treated for metastatic melanoma

3. What is Ipilimumab-induced autoimmune hypophysitis?

4. Autoimmune Hypophysitis (AH)
A new and defined clinical entity occurring as a side effect of ipilimumab, a monoclonal antibody that blocks cytotoxic T-lymphocyte antigen-4 (CTLA-4)
Presents insidiously and have life-threatening complications related to hypocortisolism, hence a high index of clinical suspicion must be exerted
High doses of steroids show radiographic resolution and variable improvement in pituitary hormone function
Ipilimumab should continue to be prescribed as treatment for metastatic malignancies; however, close clinical observation of progress must be maintained.
Further studies are required to determine the safety of continuing therapy with ipilimumab in patients who have developed AH while on treatment.
Ipilimumab-induced hypophysitis is a common side-effect with frequent hormonal deficiencies at diagnosis. Usually,
hormonal deficiencies improved, except for corticotroph function. Patients receiving these immunomodulatory therapies
should be closely monitored especially by systematic baseline hormone measurements after the third infusion and remain
at a risk of adrenal insufficiency in the long-term.
Eur J Endocrinol 2015;172:195–204

5. Ipilimumab-Induced Autoimmune Hypophysitis
Pre High Dose Steroids
Post High Dose Steroids

6. Ipilimumab-Induced Autoimmune Hypophysitis