Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders
Abstract This study aims to investigate the clinical characteristics of programmed cell death protein-1 (PD-1) or programmed cell death ligand-1 (PD-L1) inhibitors-induced pituitary injury (pituitary-irAE) by comparing with other pituitary diseases. We retrospectively reviewed clinical records of pa...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-05563-3 |
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| author | Yan Xiao Deyue Jiang Shengjie Wang Lei Fu Lingtong Ye Erhan Zheng Zhaohui Lv Yiming Mu Wenwen Gong Qinghua Guo |
| author_facet | Yan Xiao Deyue Jiang Shengjie Wang Lei Fu Lingtong Ye Erhan Zheng Zhaohui Lv Yiming Mu Wenwen Gong Qinghua Guo |
| author_sort | Yan Xiao |
| collection | DOAJ |
| description | Abstract This study aims to investigate the clinical characteristics of programmed cell death protein-1 (PD-1) or programmed cell death ligand-1 (PD-L1) inhibitors-induced pituitary injury (pituitary-irAE) by comparing with other pituitary diseases. We retrospectively reviewed clinical records of patients who were admitted for pituitary-irAE, idiopathic isolated ACTH deficiency (IIAD), and lymphocytic hypophysitis (LYH) from January 2015 to June 2024. Among 3689 patients treated with PD-1/PD-L1 inhibitors, 0.596% patients developed pituitary-irAE. The mean age of onset was 59.41 ± 10.69 years, with 13 patients (59.09%) being male. The median duration from symptom onset to confirmed diagnosis was 5.50 (2.00, 9.25) months. The clinical symptoms were similar between pituitary-irAE and IIAD, which mainly manifested as fatigue and appetite loss. Polydipsia/polyuria and amenorrhea/menstrual disorders were mainly found in patients with LYH. Central adrenal insufficiency was observed in all patients with pituitary-irAE, with cortisol concentrations typically falling below the detectable limit. Pituitary MRI appeared normal in 52.63% patients with pituitary-irAE. Furthermore, some patients with pituitary-irAE exhibited partial or complete functional recovery of the pituitary gland after hormone replacement therapy. The clinical manifestations observed in patients with pituitary-irAE are analogous to those seen in individuals with IIAD, yet they differ from the presentations of LYH. |
| format | Article |
| id | doaj-art-acd3bdc50b1f4e009f795786a2da7618 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-acd3bdc50b1f4e009f795786a2da76182025-08-20T04:01:36ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-05563-3Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disordersYan Xiao0Deyue Jiang1Shengjie Wang2Lei Fu3Lingtong Ye4Erhan Zheng5Zhaohui Lv6Yiming Mu7Wenwen Gong8Qinghua Guo9Department of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Clinical Medicine, The Capital Medical UniversityDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Pharmacy, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalAbstract This study aims to investigate the clinical characteristics of programmed cell death protein-1 (PD-1) or programmed cell death ligand-1 (PD-L1) inhibitors-induced pituitary injury (pituitary-irAE) by comparing with other pituitary diseases. We retrospectively reviewed clinical records of patients who were admitted for pituitary-irAE, idiopathic isolated ACTH deficiency (IIAD), and lymphocytic hypophysitis (LYH) from January 2015 to June 2024. Among 3689 patients treated with PD-1/PD-L1 inhibitors, 0.596% patients developed pituitary-irAE. The mean age of onset was 59.41 ± 10.69 years, with 13 patients (59.09%) being male. The median duration from symptom onset to confirmed diagnosis was 5.50 (2.00, 9.25) months. The clinical symptoms were similar between pituitary-irAE and IIAD, which mainly manifested as fatigue and appetite loss. Polydipsia/polyuria and amenorrhea/menstrual disorders were mainly found in patients with LYH. Central adrenal insufficiency was observed in all patients with pituitary-irAE, with cortisol concentrations typically falling below the detectable limit. Pituitary MRI appeared normal in 52.63% patients with pituitary-irAE. Furthermore, some patients with pituitary-irAE exhibited partial or complete functional recovery of the pituitary gland after hormone replacement therapy. The clinical manifestations observed in patients with pituitary-irAE are analogous to those seen in individuals with IIAD, yet they differ from the presentations of LYH.https://doi.org/10.1038/s41598-025-05563-3Pituitary dysfunction induced by immune checkpoint inhibitorsProgrammed cell death-1 proteinProgrammed cell death ligand-1Idiopathic isolated ACTH deficiencyLymphocytic hypophysitis |
| spellingShingle | Yan Xiao Deyue Jiang Shengjie Wang Lei Fu Lingtong Ye Erhan Zheng Zhaohui Lv Yiming Mu Wenwen Gong Qinghua Guo Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders Scientific Reports Pituitary dysfunction induced by immune checkpoint inhibitors Programmed cell death-1 protein Programmed cell death ligand-1 Idiopathic isolated ACTH deficiency Lymphocytic hypophysitis |
| title | Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders |
| title_full | Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders |
| title_fullStr | Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders |
| title_full_unstemmed | Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders |
| title_short | Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders |
| title_sort | clinical characteristics and comparative analysis of pd 1 pd l1 inhibitor induced pituitary dysfunction versus other pituitary disorders |
| topic | Pituitary dysfunction induced by immune checkpoint inhibitors Programmed cell death-1 protein Programmed cell death ligand-1 Idiopathic isolated ACTH deficiency Lymphocytic hypophysitis |
| url | https://doi.org/10.1038/s41598-025-05563-3 |
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