A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab

Immune checkpoint inhibitors (ICIs) have become a focal point in cancer immunotherapy, though their utilization is also linked to the occurrence of diverse immune-related adverse events (irAEs). Herein, we present details of a 42-year-old woman diagnosed with a malignant vaginal melanoma who underwe...

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Main Authors: Yonekazu Kidawara, Manabu Kadoya, Miki Kakutani-Hatayama, Hidenori Koyama
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2024/4662803
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author Yonekazu Kidawara
Manabu Kadoya
Miki Kakutani-Hatayama
Hidenori Koyama
author_facet Yonekazu Kidawara
Manabu Kadoya
Miki Kakutani-Hatayama
Hidenori Koyama
author_sort Yonekazu Kidawara
collection DOAJ
description Immune checkpoint inhibitors (ICIs) have become a focal point in cancer immunotherapy, though their utilization is also linked to the occurrence of diverse immune-related adverse events (irAEs). Herein, we present details of a 42-year-old woman diagnosed with a malignant vaginal melanoma who underwent ICI therapy with the combination of nivolumab and ipilimumab. Approximately two months after initiating therapy, the patient manifested destructive thyroiditis and fulminant type 1 diabetes mellitus, thus necessitating intensive insulin therapy. Following the onset of adrenocorticotropic hormone deficiency, frequent hypoglycemic episodes prompted the initiation of replacement therapy with hydrocortisone. Human leukocyte antigen (HLA)-DNA typing revealed the presence of HLA-DRB1∗04 : 05 and DQB1∗04 : 01. HLA-DR4 has been suggested to be associated with the development of multiple endocrine irAEs. This is the first reported case of three endocrine irAEs occurring within a short period, in which the presence of HLA-DR4 may have contributed to the pathogenesis.
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institution DOAJ
issn 2090-651X
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publishDate 2024-01-01
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series Case Reports in Endocrinology
spelling doaj-art-d6fa256405d247ce99dfc8700910a2ee2025-08-20T03:23:51ZengWileyCase Reports in Endocrinology2090-651X2024-01-01202410.1155/2024/4662803A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and IpilimumabYonekazu Kidawara0Manabu Kadoya1Miki Kakutani-Hatayama2Hidenori Koyama3Department of DiabetesDepartment of DiabetesDepartment of DiabetesDepartment of DiabetesImmune checkpoint inhibitors (ICIs) have become a focal point in cancer immunotherapy, though their utilization is also linked to the occurrence of diverse immune-related adverse events (irAEs). Herein, we present details of a 42-year-old woman diagnosed with a malignant vaginal melanoma who underwent ICI therapy with the combination of nivolumab and ipilimumab. Approximately two months after initiating therapy, the patient manifested destructive thyroiditis and fulminant type 1 diabetes mellitus, thus necessitating intensive insulin therapy. Following the onset of adrenocorticotropic hormone deficiency, frequent hypoglycemic episodes prompted the initiation of replacement therapy with hydrocortisone. Human leukocyte antigen (HLA)-DNA typing revealed the presence of HLA-DRB1∗04 : 05 and DQB1∗04 : 01. HLA-DR4 has been suggested to be associated with the development of multiple endocrine irAEs. This is the first reported case of three endocrine irAEs occurring within a short period, in which the presence of HLA-DR4 may have contributed to the pathogenesis.http://dx.doi.org/10.1155/2024/4662803
spellingShingle Yonekazu Kidawara
Manabu Kadoya
Miki Kakutani-Hatayama
Hidenori Koyama
A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab
Case Reports in Endocrinology
title A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab
title_full A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab
title_fullStr A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab
title_full_unstemmed A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab
title_short A Case in Which HLA-DR4 is Involved in the Development of Complex Immune-Related Endocrinological Adverse Events following Combination Therapy with Nivolumab and Ipilimumab
title_sort case in which hla dr4 is involved in the development of complex immune related endocrinological adverse events following combination therapy with nivolumab and ipilimumab
url http://dx.doi.org/10.1155/2024/4662803
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