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IPILIMUMAB - A NOVEL IMMUNOMODULATING THERAPY CAUSING AUTOIMMUNE HYPOPHYSITIS: A CASE REPORT AND REVIEW.
MedLine Citation:
PMID:  22495490     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Ipilimumab (Yervoy, Medarex and Bristol-Myers Squibb) is a human monoclonal antibody against cytotoxic T lymphocyte antigen-4 (CTLA-4), which enhances co-stimulation of cytotoxic T lymphocytes, resulting in their proliferation and an anti-tumour response. It is licensed for the treatment of unresectable or metastatic malignant melanoma, while multiple clinical trials using this medication in the treatment of other malignancies are ongoing.As a clinical response to ipilimumab results from immunostimulation, predictably it generates autoimmunity as well, causing immune-related adverse events in the majority of patients. Of those, endocrinopathies are frequently seen, and in particular autoimmune lymphocytic hypophysitis with anterior panhypopituitarism has been reported a number of times in North America.We present a case of a male referred to our department with manifestations of anterior panhypopituitarism after his 3rd dose of ipilimumab for metastatic malignant melanoma, and we discuss the management of his case in the light of previous reports. We also review the published literature on the presenting symptoms, time to presentation, investigations, imaging, treatment and follow-up of ipilimumab-induced autoimmune lymphocytic hypophysitis.
Authors:
Agata Juszczak; Avinash Gupta; Niki Karavitaki; Mark R Middleton; Ashley Grossman
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-10
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
A Juszczak, Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism,Churchill Hospital, University of Oxford, Oxford, United Kingdom.
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