Log in with your email address username.

×

Attention doctorportal newsletter subscribers,

After December 2018, we will be moving elements from the doctorportal newsletter to MJA InSight newsletter and rebranding it to Insight+. If you’d like to continue to receive a newsletter covering the latest on research and perspectives in the medical industry, please subscribe to the Insight+ newsletter here.

As of January 2019, we will no longer be sending out the doctorportal email newsletter. The final issue of this newsletter will be distributed on 13 December 2018. Articles from this issue will be available to view online until 31 December 2018.

Ipilimumab-induced hypophysitis: early Australian experience

- Featured Image

To the Editor: We report two men aged in their 60s receiving ipilimumab for metastatic melanoma who presented with headache and constitutional symptoms after the third 3-weekly dose, and were diagnosed with ipilimumab-induced hypophysitis. Ipilimumab is a monoclonal antibody that binds to cytotoxic T lymphocyte-associated antigen 4, resulting in T-cell activation and proliferation. It was the first therapy to yield a survival benefit in metastatic melanoma,1 but at the cost of frequent immune-related adverse events.2

Patient 1 experienced headache, fatigue, postural lightheadedness, anorexia and asthenia. Morning blood test results before steroid administration were consistent with central hypocortisolism (serum cortisol, < 28 nmol/L [reference interval (RI), 70–650 nmol/L]; inappropriately normal adrenocorticotropic hormone [ACTH], 1.2 pmol/L [RI, 0–12.0 pmol/L]), hypothyroidism (low thyroid-stimulating hormone [TSH], 0.2 mIU/L [RI, 0.4–4.0 mIU/L]; low free thyroxine [FT4], 8.9 pmol/L [RI, 9.0–19.0 pmol/L]; normal free triiodothyronine [FT3], 4.7 pmol/L [RI, 2.6–6.0 pmol/L]), and hypogonadism (low testosterone, 2.8 nmol/L [9.5–28.0 nmol/L]; insufficiently raised follicle-stimulating…

email