Journal of Diagnostics Concepts & Practice >

2022 , Vol. 21 >Issue 06: 741 - 745

DOI: https://doi.org/10.16150/j.1671-2870.2022.06.13

Case report

PD-L1 inhibitors-induced hypophysitis in a patient with small cell lung cancer: a case report and literatures review

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  • 1. Pulmonary and Critical Care Medicine,Wuxi Xinwu District Xinrui Hospital, Wuxi, Jiangsu 214000
    2. Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025
    3. Institute of Respiratory Diseases,Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2022-07-26

  Online published: 2023-04-23

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Abstract

This paper reports a case of immune-related hypophysitis (irH) after 7 cycles of treatment with Duva-lizumab, a PD-L1 (programmed cell death-ligand 1) inhibitor in a patient with small cell lung cancer. The patient showed fatigue, anorexia, hypotension, with lower serum levels of adrenocorticotropic hormone (ACTH) (3.8 ng/L) and thyroid stimulating hormone（TSH）(0.266 μIU/mL) than those before treatment (48 ng/L, 4.64 μIU/mL). The patient′s condition gradually improved with hydrocortisone replacement treatment. PubMed, Wanfang, and CNKI databases were searched.A total of 316 cases have been reported in recent 10 years, including 10 cases with irH caused by PD-1/PD-L1 in 84 lung cancer patients, mainly manifested as fatigue, anorexia, weight loss, and hypotension. Compared with cytotoxic T lymphocyte associated protein 4 antibody blocker treatment, the incidence of PD-1/PD-L1 induced-irH is low, and onset of irH is later. Pituitary MRI images mostly showed no abnormality. However, the condition of the patients was often critical or even life-threatening, which need to pay attention to.

Key words： Programmed cell death-ligand 1 inhibitor; Small cell lung cancer; Immune-related hypophysitis

Cite this article

ZHANG Meiling, ZHU Xiaobang, SHONG Ailing, ZHOU Jianping, LI Qingyun . PD-L1 inhibitors-induced hypophysitis in a patient with small cell lung cancer: a case report and literatures review[J]. Journal of Diagnostics Concepts & Practice, 2022 , 21(06) : 741 -745 . DOI: 10.16150/j.1671-2870.2022.06.13

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