{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:23:47Z","timestamp":1783488227711,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,10,1]],"date-time":"2015-10-01T00:00:00Z","timestamp":1443657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2015,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Ipilimumab (Y<\/jats:styled-content>ervoy; B<\/jats:styled-content>ristol\u2010M<\/jats:styled-content>yers S<\/jats:styled-content>quibb) is a novel fully humanised monoclonal antibody that blocks cytotoxic T<\/jats:styled-content>\u2010lymphocyte antigen 4, an immune checkpoint molecule, to augment anti\u2010tumour T<\/jats:styled-content>\u2010cell responses. It is associated with significant immune\u2010related side\u2010effects including hypophysitis.<\/jats:p><\/jats:sec>Aim<\/jats:title>We reviewed the clinical and biochemical characteristics of 10 patients with ipilimumab\u2010induced hypophysitis (IH<\/jats:styled-content>), and developed guidelines for the early detection and management of IH<\/jats:styled-content> based on our experiences at three major teaching hospitals in Sydney.<\/jats:p><\/jats:sec>Methods<\/jats:title>All patients were evaluated at the C<\/jats:styled-content>rown P<\/jats:styled-content>rincess M<\/jats:styled-content>ary C<\/jats:styled-content>ancer C<\/jats:styled-content>entre and D<\/jats:styled-content>epartment of E<\/jats:styled-content>ndocrinology, W<\/jats:styled-content>estmead H<\/jats:styled-content>ospital, D<\/jats:styled-content>epartment of E<\/jats:styled-content>ndocrinology, R<\/jats:styled-content>oyal P<\/jats:styled-content>rince A<\/jats:styled-content>lfred H<\/jats:styled-content>ospital, the M<\/jats:styled-content>elanoma I<\/jats:styled-content>nstitute A<\/jats:styled-content>ustralia and M<\/jats:styled-content>acarthur C<\/jats:styled-content>ancer T<\/jats:styled-content>herapy C<\/jats:styled-content>entre, C<\/jats:styled-content>ampbelltown H<\/jats:styled-content>ospital from 2010 to 2014. Relevant data were extracted by review of medical records. Main outcome measures included clinical features, hormone profile and radiological findings associated with IH<\/jats:styled-content>, and presence of pituitary recovery.<\/jats:p><\/jats:sec>Results<\/jats:title>Ten patients were identified with IH<\/jats:styled-content>. In four patients who underwent monitoring of plasma cortisol, there was a fall in levels in the weeks prior to presentation. The pituitary\u2013adrenal and pituitary\u2013thyroid axes were affected in the majority of patients, with the need for physiological hormone replacement. Imaging abnormalities were identified in five of 10 patients, and resolved without high\u2010dose glucocorticoid therapy. To date, all patients remain on levothyroxine and hydrocortisone replacement, where appropriate.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>There is significant morbidity associated with development of IH<\/jats:styled-content>. We suggest guidelines to assist with early recognition and therapeutic intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12819","type":"journal-article","created":{"date-parts":[[2015,5,26]],"date-time":"2015-05-26T06:57:51Z","timestamp":1432623471000},"page":"1066-1073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Ipilimumab\u2010induced hypophysitis in melanoma patients: an A<\/scp>ustralian case series"],"prefix":"10.1111","volume":"45","author":[{"given":"T.","family":"Lam","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Crown Princess Mary Cancer Centre Westmead Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M. K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Crown Princess Mary Cancer Centre Westmead Hospital Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Central Coast Cancer Centre Gosford Hospital Gosford New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. N.","family":"Sweeting","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Department of Endocrinology Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-6482","authenticated-orcid":false,"given":"S. M. C.","family":"De Sousa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St Vincent's Hospital Sydney New South Wales Australia"},{"name":"Hormones and Cancer Group Garvan Institute of Medical Research Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Clements","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Crown Princess Mary Cancer Centre Westmead Hospital Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"Carlino","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Crown Princess Mary Cancer Centre Westmead Hospital Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Melanoma Institute of Australia Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. V.","family":"Long","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Melanoma Institute of Australia Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Tonks","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St Vincent's Hospital Sydney New South Wales Australia"},{"name":"Diabetes and Metabolism Division Garvan Institute of Medical Research Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Chua","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Department of Endocrinology Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. F.","family":"Kefford","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Crown Princess Mary Cancer Centre Westmead Hospital Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"Melanoma Institute of Australia Sydney New South Wales Australia"},{"name":"Australian School of Advanced Medicine Macquarie University Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. R","family":"Chipps","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Crown Princess Mary Cancer Centre Westmead Hospital Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003466"},{"key":"e_1_2_7_3_1","unstructured":"United States Department of Health and Human Services.National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 NCI NIH DHHS.2009 NIH publication # 09\u20107473."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27969"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2306"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.cji.0000208259.73167.58"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-13-0499"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja13.10448"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00803"},{"key":"e_1_2_7_10_1","unstructured":"Bristol\u2010Myers Squibb.Yervoy (ipilimumab): immune\u2010mediated adverse reaction management guide.2011[cited 2015 Feb 21]. 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