title: Ipilimumab-induced hypophysitis and uveitis in a patient with metastatic melanoma and a history of ipilimumab-induced skin rash.
abstract: Ipilimumab, a monoclonal antibody that blocks cytotoxic T-lymphocyte-associated antigen-4, leading to enhanced T-cell activation and proliferation, is associated with improved overall survival in melanoma. Its use can result in immune-related adverse events, the most common of which are skin rash, diarrhea, and colitis. Ipilimumab-induced hypophysitis is uncommon, mostly involves anterior pituitary, and is associated with abnormalities in pituitary MRI, whereas uveitis has been rarely reported. These immune-related adverse events occur during therapy. This report describes a patient who developed uveitis and hypophysitis involving both anterior and posterior pituitary, without MRI findings more than 3 weeks after the fourth dose of ipilimumab. This case illustrates the unusual presentation of and diagnostic challenges associated with ipilimumab-induced immune-related adverse events.
authors.affiliation: From the University of Nebraska Medical Center, Department of Internal Medicine, Division of Nephrology; Creighton University Medical Center, Department of Internal Medicine; University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology; VA Nebraska-Western Iowa Health Care System, Department of Internal Medicine; and VA Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology, Omaha, Nebraska.
authors.forename: Neelima N
authors.initials: NN
authors.lastname: Nallapaneni
authors.affiliation: From the University of Nebraska Medical Center, Department of Internal Medicine, Division of Nephrology; Creighton University Medical Center, Department of Internal Medicine; University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology; VA Nebraska-Western Iowa Health Care System, Department of Internal Medicine; and VA Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology, Omaha, Nebraska.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Mourya
authors.affiliation: From the University of Nebraska Medical Center, Department of Internal Medicine, Division of Nephrology; Creighton University Medical Center, Department of Internal Medicine; University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology; VA Nebraska-Western Iowa Health Care System, Department of Internal Medicine; and VA Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology, Omaha, Nebraska.
authors.forename: Vijaya Raj
authors.initials: VR
authors.lastname: Bhatt
authors.affiliation: From the University of Nebraska Medical Center, Department of Internal Medicine, Division of Nephrology; Creighton University Medical Center, Department of Internal Medicine; University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology; VA Nebraska-Western Iowa Health Care System, Department of Internal Medicine; and VA Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology, Omaha, Nebraska.
authors.forename: Sakshi
authors.initials: S
authors.lastname: Malhotra
authors.affiliation: From the University of Nebraska Medical Center, Department of Internal Medicine, Division of Nephrology; Creighton University Medical Center, Department of Internal Medicine; University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology; VA Nebraska-Western Iowa Health Care System, Department of Internal Medicine; and VA Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology, Omaha, Nebraska.
authors.forename: Apar Kishor
authors.initials: AK
authors.lastname: Ganti
authors.affiliation: From the University of Nebraska Medical Center, Department of Internal Medicine, Division of Nephrology; Creighton University Medical Center, Department of Internal Medicine; University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology; VA Nebraska-Western Iowa Health Care System, Department of Internal Medicine; and VA Nebraska-Western Iowa Health Care System, and University of Nebraska Medical Center, Department of Internal Medicine, Division of Hematology and Oncology, Omaha, Nebraska.
authors.forename: Ketki K
authors.initials: KK
authors.lastname: Tendulkar
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D060908:CTLA-4 Antigen / Q000037:antagonists & inhibitors / Q000276:immunology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000276:immunology / Q000473:pathology*; D005076:Exanthema / Q000139:chemically induced / Q000276:immunology / Q000473:pathology*; D006801:Humans; D000074324:Ipilimumab; D008297:Male; D008545:Melanoma / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010900:Pituitary Diseases / Q000139:chemically induced / Q000473:pathology; D014605:Uveitis / Q000139:chemically induced / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D060908:CTLA-4 Antigen; D000074324:Ipilimumab