Hyponatremia associated with Ipilimumab-induced hypophysitis.
A 75-year-old woman with a history of stage IV metastatic melanoma underwent treatment with the CTLA-4 blocking agent Ipilimumab. She presented 2 months after initiating treatment with a severe headache. Laboratories were consistent with severe hyponatremia. MRI of the brain revealed enlargement of the pituitary gland, enhancement of the infundibulum, and an enhancing, centrally necrotic foci in the anterior pituitary. Based on the clinical and radiographic findings, she was diagnosed with treatment-related syndrome of inappropriate antidiuretic hormone secretion (SIADH). Effective treatment consisted of fluid restriction, hyperosmolar therapy, and steroids.
Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA.
Zachary R
ZR
Barnard
Brian P
BP
Walcott
Kristopher T
KT
Kahle
Brian V
BV
Nahed
Jean Valery
JV
Coumans
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000503:physiopathology; D007177:Inappropriate ADH Syndrome / Q000209:etiology / Q000503:physiopathology; D000074324:Ipilimumab; D008545:Melanoma / Q000188:drug therapy; D010900:Pituitary Diseases / Q000139:chemically induced* / Q000150:complications* / Q000503:physiopathology
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab
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