Frontiers in Endocrinology (Oct 2021)

Case Report: A Variety of Immune-Related Adverse Events Triggered by Immune Checkpoint Inhibitors in a Subject With Malignant Melanoma: Destructive Thyroiditis, Aseptic Meningitis and Isolated ACTH Deficiency

  • Yukino Katakura,
  • Tomohiko Kimura,
  • Takashi Kusano,
  • Fuminori Tatsumi,
  • Yuichiro Iwamoto,
  • Junpei Sanada,
  • Yoshiro Fushimi,
  • Masashi Shimoda,
  • Kenji Kohara,
  • Shuhei Nakanishi,
  • Kohei Kaku,
  • Tomoatsu Mune,
  • Hideaki Kaneto

DOI
https://doi.org/10.3389/fendo.2021.722586
Journal volume & issue
Vol. 12

Abstract

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Recently, immune checkpoint inhibitors have been drawing much attention as cancer immunotherapy, but it has been shown that various immune-related adverse events (irAEs) are induced by immune checkpoint inhibitors in various organs, which has become one of the serious issues at present. A 58-year-old Japanese male with malignant melanoma was treated with nivolumab and/or ipilimumab. During the period of treatment, he suffered from various irAEs. Firstly, about 1 month after starting nivolumab monotherapy, destructive thyroiditis was induced, and so we started replacement therapy with levothyroxine. Secondly, about 1 month after starting nivolumab and ipilimumab combination therapy, aseptic meningitis was induced. We stopped both drugs and started steroid therapy with prednisolone. Finally, about 9 months after restarting nivolumab, isolated adrenocorticotropic hormone (ACTH) deficiency was induced, and so we started replacement therapy with hydrocortisone. Taken together, we should bear in mind the possibility of a variety of irAEs when we use immune checkpoint inhibitors.

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