Ipilimumab-Induced Hypophysitis and Uveitis in a Patient With Metastatic Melanoma and History of Ipilimumab-Induced Skin Rash
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 immunerelated 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.
Target Audience
This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.
Learning Objectives
Upon completion of this activity, participants will be able to:
- Recognize the typical timing pattern for the most frequently reported immune-related adverse events associated with ipilimumab
- Describe the unusual presentation of rare complications associated with ipilimumab such as hypophysitis and uveitis
Neelima N. Nallapaneni, MBBS University of Nebraska Medical Center Department of Internal Medicine, Division of Nephrology Omaha, Nebraska | Sakshi Malhotra, MBBS VA Nebraska-Western Iowa Health Care System Department of Internal Medicine Omaha, Nebraska |
Rajesh Mourya, MBBS Creighton University Medical Center Department of Internal Medicine Omaha, Nebraska | Apar Kishor Ganti, MD, MS VA Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center Department of Internal Medicine, Division of Hematology and Oncology Omaha, Nebraska |
Vijaya Raj Bhatt, MBBS University of Nebraska Medical Center Department of Internal Medicine, Division of Hematology and Oncology Omaha, Nebraska | Ketki K. Tendulkar, MBBS University of Nebraska Medical Center Department of Internal Medicine, Division of Nephrology Omaha, Nebraska |
Available Credit
- 1.00 Participation
- 1.00 Nurse
- 1.00 Physician
Price
Required Hardware/software
To access this activity, users will need:
- A device with an Internet connection
- Adobe Reader or other PDF reader software for article and certificate viewing/printing