title: Inflammatory Orbitopathy Associated With Ipilimumab.
abstract: In this case report, the clinical presentation of an inflammatory orbitopathy seen following treatment with ipilimumab is described. After 3 rounds of ipilimumab (10 mg/kg) treatment for Stage III metastatic melanoma, the subject of this case report developed acute eye pain and proptosis. At initial presentation, she had marked proptosis and diffuse severe ophthalmoparesis. After treatment with high-dose steroids, over a period of 6 months, the symptoms gradually resolved fully. Although the condition may mimic thyroid-associated orbitopathy, imaging and laboratory features suggest that the orbitopathy associated with ipilimumab is not a secondary effect of thyroid dysfunction but a distinct inflammatory condition. The authors conclude that immune-related side effects can occur with biologic agents used to treat malignancies and these side-effects can involve the eye. This case illustrates the occurrence of an inflammatory orbitopathy associated with ipilimumab treatment.
authors.affiliation: *Scheie Eye Institute, Department of Ophthalmology, and †Departments of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Claire A
authors.initials: CA
authors.lastname: Sheldon
authors.forename: Julia
authors.initials: J
authors.lastname: Kharlip
authors.forename: Madhura A
authors.initials: MA
authors.lastname: Tamhankar
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007249:Inflammation / Q000139:chemically induced* / Q000175:diagnosis; D000074324:Ipilimumab; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D009915:Orbit / Q000000981:diagnostic imaging*; D009916:Orbital Diseases / Q000139:chemically induced* / Q000175:diagnosis; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary; D014463:Ultrasonography; D000096142:Cutaneous Malignant Melanoma
chemical_list: D000911:Antibodies, Monoclonal; D000074324:Ipilimumab