{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:34:34Z","timestamp":1783532074093,"version":"3.55.0"},"reference-count":22,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,13]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Cancer immunotherapy has been used in several malignancies with clinical benefit. Despite the clinical success, immune-related adverse events are frequent and endocrinopathies can be particularly severe. We report a 55-year-old male patient with stage IV pulmonary carcinoma treated with nivolumab who presented with thyroid dysfunction after the sixth administration of the drug. One year after thyroid dysfunction, the patient complained of severe fatigue, asthenia and weight loss. Laboratory testing showed low morning cortisol with undetected adrenocorticotropic hormone; other pituitary hormones were normal and MRI showed homogeneous enhancement of the pituitary gland and no space-occupying lesions. The diagnosis of nivolumab-induced hypophysitis was made and replacement treatment with hydrocortisone was started with clinical improvement. This case demonstrates that patients under immunotherapy are at risk for a large spectrum of endocrine dysfunctions that may worsen their prognosis. Close monitoring of these patients is warranted.<\/jats:p>","DOI":"10.1136\/bcr-2019-231236","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T07:39:58Z","timestamp":1567064398000},"page":"e231236","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Nivolumab-induced hypothyroidism followed by isolated ACTH deficiency"],"prefix":"10.1136","volume":"12","author":[{"given":"Catarina","family":"Martins Machado","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00facia","family":"Almeida Santos","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Barroso","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jo\u00e3o","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,28]]},"reference":[{"key":"2025082707362011000_12.8.e231236.1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1055\/a-0843-3366","article-title":"A systematic review and meta-analysis of endocrine-related adverse events associated with immune checkpoint inhibitors","volume":"51","author":"de Filette","year":"2019","journal-title":"Horm Metab 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