Hypophysitis associated with immune check piont inhibitors treatment: A case report and literature review.

Abstract

Immune checkpoint inhibitors (ICPis) significantly improves survival in a number of cancer patients by blocking immunosuppressive molecules and reactivating the function of effector T cells to specifically kil tumor cells. This article reports a case of secondary hypoadrenocorticism caused by programmed death 1 (PD-1) inhibitor related hypophysitis. A 65-year-old male patient received immunotherapy for right lung squamous cell carcinoma invading the chest wall (cT4N2M0) for 4 times. Two weeks after the last immunotherapy treatment, the patient experienced poor appetite and fatigue. Examination results indicated severe hyponatremia, and there was no improvement even after repeated supplementation with high-concentration sodium chloride. After further examination, glucocorticoid supplementation was given to the patient and his clinical symptoms were significantly improved. It is recommended that patients receiving ICPis should be asked in detail about their medical history before initiating treatment, baseline screening should be carried out reasonably, and regular follow-up about endocrine gland hormone and related biochemical indexes after treatment should be carried out. Meanwhile, it is necessary to pay attention to the related symptoms and signs of patients in order to find endocrine gland adverse reactions in time.