Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis

ObjectiveTo analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-related hypophysitis. MethodsA retrospective analysis was conducted on patients diagnosed with ICI-related hypophysitis and treated at the Department of Endocrinology, The First Affiliated Hospital with Nanjing Med...

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Main Authors: Zhixiao WANG, Yun SHI, Min SUN, Xuqin ZHENG, Tao YANG, Min SHEN
Format: Article
Language:English
Published: Shanghai Chinese Clinical Medicine Press Co., Ltd. 2025-08-01
Series:Zhongguo Linchuang Yixue
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Online Access:https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250397
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author Zhixiao WANG
Yun SHI
Min SUN
Xuqin ZHENG
Tao YANG
Min SHEN
author_facet Zhixiao WANG
Yun SHI
Min SUN
Xuqin ZHENG
Tao YANG
Min SHEN
author_sort Zhixiao WANG
collection DOAJ
description ObjectiveTo analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-related hypophysitis. MethodsA retrospective analysis was conducted on patients diagnosed with ICI-related hypophysitis and treated at the Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, between January 2020 and March 2025. Clinical manifestations and prognosis of patients were analyzed. ResultsEleven patients with ICI-related hypophysitis were included. The average age was (62.27±7.63) years, and 9 patients (81.82%) were male. The median time to onset was 9.1 months, and the median number of treatment cycles received was 5. The primary initial symptoms were fatigue and anorexia. Hyponatremia was present in 3 patients (27.27%). Evaluation of anterior pituitary function revealed adrenocorticotropic hormone deficiency as the most common manifestation (90.91%, 10/11), followed by hyperprolactinemia (81.82%, 9/11). Posterior pituitary function remained normal in all patients. Pituitary magnetic resonance imaging showed no abnormality in 4 patients (44.44%). Thyroid dysfunction was observed in 6 patients (54.55%), one of whom (9.09%) also exhibited pancreatic endocrine dysfunction. The average follow-up duration was 36.5 months. Eight patients (72.73%) were alive at the last follow-up. None of the patients recovered their pituitary hormone function. ConclusionsEndocrine adverse events induced by ICIs can involve multiple glandular systems. Clinicians should be highly vigilant for the possibility of ICI-induced hypophysitis in patients receiving ICIs who present with symptoms such as fatigue, anorexia, and hyponatremia.
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spelling doaj-art-77ae8970b47e4865bfda9fbb569f80292025-08-26T01:29:39ZengShanghai Chinese Clinical Medicine Press Co., Ltd.Zhongguo Linchuang Yixue1008-63582025-08-0132452953510.12025/j.issn.1008-6358.2025.2025039720250397Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitisZhixiao WANG0Yun SHI1Min SUN2Xuqin ZHENG3Tao YANG4Min SHEN5Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaDepartment of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu, ChinaObjectiveTo analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-related hypophysitis. MethodsA retrospective analysis was conducted on patients diagnosed with ICI-related hypophysitis and treated at the Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, between January 2020 and March 2025. Clinical manifestations and prognosis of patients were analyzed. ResultsEleven patients with ICI-related hypophysitis were included. The average age was (62.27±7.63) years, and 9 patients (81.82%) were male. The median time to onset was 9.1 months, and the median number of treatment cycles received was 5. The primary initial symptoms were fatigue and anorexia. Hyponatremia was present in 3 patients (27.27%). Evaluation of anterior pituitary function revealed adrenocorticotropic hormone deficiency as the most common manifestation (90.91%, 10/11), followed by hyperprolactinemia (81.82%, 9/11). Posterior pituitary function remained normal in all patients. Pituitary magnetic resonance imaging showed no abnormality in 4 patients (44.44%). Thyroid dysfunction was observed in 6 patients (54.55%), one of whom (9.09%) also exhibited pancreatic endocrine dysfunction. The average follow-up duration was 36.5 months. Eight patients (72.73%) were alive at the last follow-up. None of the patients recovered their pituitary hormone function. ConclusionsEndocrine adverse events induced by ICIs can involve multiple glandular systems. Clinicians should be highly vigilant for the possibility of ICI-induced hypophysitis in patients receiving ICIs who present with symptoms such as fatigue, anorexia, and hyponatremia.https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250397immune checkpoint inhibitorimmune-related adverse eventhypophysitisclinical characteristic
spellingShingle Zhixiao WANG
Yun SHI
Min SUN
Xuqin ZHENG
Tao YANG
Min SHEN
Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis
Zhongguo Linchuang Yixue
immune checkpoint inhibitor
immune-related adverse event
hypophysitis
clinical characteristic
title Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis
title_full Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis
title_fullStr Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis
title_full_unstemmed Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis
title_short Analysis of the clinical characteristics of immune checkpoint inhibitor-related hypophysitis
title_sort analysis of the clinical characteristics of immune checkpoint inhibitor related hypophysitis
topic immune checkpoint inhibitor
immune-related adverse event
hypophysitis
clinical characteristic
url https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250397
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