高级检索
当前位置: 首页 > 详情页

程序性细胞死亡蛋白1抑制剂相关性垂体炎临床特征分析

Clinical characteristics of programmed cell death-1 inhibitor-associated hypophysitis

文献详情

资源类型:
Pubmed体系:

收录情况: ◇ 统计源期刊 ◇ 北大核心 ◇ CSCD-C ◇ 卓越:梯队期刊 ◇ 中华系列

机构: [1]河北大学附属医院内分泌科,保定 071030 [2]河北医科大学第三医院内分泌科,石家庄 050051 [3]河北大学附属医院肿瘤内科 河北省肿瘤放化疗机制与规程研究重点实验室,保定 071030
出处:
ISSN:

关键词: 垂体功能减退症 PD‑1 抑制剂 免疫疗法 免疫相关不良事件

摘要:
Objective: To explore the clinical features of programmed cell death-1 (PD-1) inhibitor-associated hypophysitis and improve the understanding of the disease. Methods: For the present retrospective case series study, the clinical data of patients with PD-1 inhibitor-associated hypophysitis who were treated at the Affiliated Hospital of Hebei University and the 3rd Hospital of Hebei Medical University from January 2020 to May 2023 were collected for analysis of clinical manifestations and prognosis. Results: Fifteen cases of PD-1 inhibitor-induced hypophysitis were included, with 13 males and 2 females. The mean age of onset was (62.1±7.5) years, and the median time of onset was 6.5 (4.7, 11.6) cycles of PD-1 inhibitor. At diagnosis, 14 patients complained of gastrointestinal symptoms, and 12 patients complained of fatigue. There were 12, 1, 1, 5, and 1 cases of hyponatremia, hypokalemia, hypoglycemia, hypotension, and fever, respectively. Secondary adrenocortical insufficiency occurred in all cases. Moreover, four patients had secondary hypothyroidism, and two patients had secondary hypogonadism. Posterior pituitary hypofunction was not found. Pituitary MRI showed one case each of vacuolar sella turcica, pituitary cystic lesion, pituitary stalk slightly shifted to the left, high metabolism in the sella turcica, and pituitary abnormal signal, while no abnormalities were found in 11 cases. The follow-up time was (47.66±11.93) weeks. At the last follow-up, one patient's serum levels of adrenocorticotropic hormone and cortisol returned to normal. Conclusions: Hypophysitis associated with PD-1 inhibitors occurs later, and gastrointestinal symptoms and fatigue are the most common clinical manifestations. PD-1 inhibitor-associated hypophysitis mainly manifests as adrenocortical hypofunction, and some cases manifest as hypothyroidism and hypogonadism. In addition, patients with PD-1 inhibitor-associated hypophysitis show no obvious imaging changes in the pituitary gland.

基金:
语种:
PubmedID:
第一作者:
第一作者机构: [1]河北大学附属医院内分泌科,保定 071030
共同第一作者:
通讯作者:
推荐引用方式(GB/T 7714):

资源点击量:15679 今日访问量:0 总访问量:1035 更新日期:2025-06-01 建议使用谷歌、火狐浏览器 常见问题

版权所有©2020 河北大学附属医院 技术支持:重庆聚合科技有限公司 地址:保定市莲池区裕华东路212号