{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:50:14Z","timestamp":1783486214667,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T00:00:00Z","timestamp":1603670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K23942"],"award-info":[{"award-number":["19K23942"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Programmed cell death\u20101 (PD\u20101) blockade therapy, an immune checkpoint treatment, can induce hypophysitis or hypopituitarism as an immune\u2010related adverse event (pituitary irAE). We aimed to clarify the clinical features of pituitary irAEs during PD\u20101 blockade therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Patients and Measurements<\/jats:title><jats:p>This retrospective study investigated consecutive patients treated with nivolumab, an anti\u2010PD\u20101 antibody, at Kyoto University Hospital between 1 September 2014 and 31 August 2019. We examined patients\u2019 baseline characteristics and analysed the clinical data of those who developed pituitary irAEs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 374 recruited patients, 7 (1.9%) developed pituitary irAEs, and each presented with isolated secondary adrenal insufficiency. In 4 patients, changes in ACTH were delayed relative to those in cortisol: when serum cortisol levels fell below the reference range, plasma ACTH levels were still normal. Pituitary irAEs were accompanied by elevated serum\u2010free T3 (fT3) levels, which resolved with glucocorticoid replacement. Serum TSH levels were not suppressed despite elevated serum fT3 levels and 1 patient even presented with high fT3 level above the reference range (fT3, 7.1\u00a0pmol\/L; free T4 (fT4), 13.9\u00a0pmol\/L; and TSH, 5.1\u00a0mIU\/L).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Isolated secondary adrenal insufficiency was a common pituitary irAE during PD\u20101 blockade therapy. This condition was accompanied by thyroid dysfunction, including elevation of fT3 without TSH suppression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14349","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T03:24:50Z","timestamp":1602300290000},"page":"258-268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical features and thyroid dysfunction in adverse events involving the pituitary gland during PD\u20101 blockade therapy"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4236-502X","authenticated-orcid":false,"given":"Ichiro","family":"Yamauchi","sequence":"first","affiliation":[{"name":"Department of Diabetes, Endocrinology and Nutrition Kyoto University Graduate School of Medicine Kyoto 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