title: Ipilimumab immune-related adverse reactions: a case report.
abstract: Ipilimumab is an immunomodulating agent approved by the Food and Drug Administration (FDA) as of March 2011 for the treatment of metastatic melanoma. The medication works by inhibiting cytotoxic T-lymphocyte antigen 4, which typically works to down-regulate the T-cell response and protects self-antigens from recognition by the immune system. Since the T-cells are no longer down-regulated by this antigen, they are allowed to proliferate, thereby helping to prevent melanoma tumor evasion. As a result of the up-regulation of the immune system, numerous immune-mediated adverse effects have been reported including colitis, dermatitis, hepatitis and rarely hypophysitis. Typically, these effects are treated with high-dose steroids and most eventually resolve. We present a case of autoimmune (lymphocytic) hypophysitis following treatment with four doses of ipilimumab 3mg/kg and discuss the work-up, treatment and prognosis of the event.
authors.affiliation: Sanford School of Medicine, University of South Dakota, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Anderson
authors.forename: Vishal
authors.initials: V
authors.lastname: Bhatia
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007018:Hypopituitarism / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology*; D007037:Hypothyroidism / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D056747:Immunomodulation / Q000187:drug effects / Q000276:immunology; D000074324:Ipilimumab; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D013974:Thyroxine / Q000627:therapeutic use; D015854:Up-Regulation / Q000187:drug effects / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D000074324:Ipilimumab; D013974:Thyroxine; D011241:Prednisone; D006854:Hydrocortisone