AUTHOR=Katakura Yukino , Kimura Tomohiko , Kusano Takashi , Tatsumi Fuminori , Iwamoto Yuichiro , Sanada Junpei , Fushimi Yoshiro , Shimoda Masashi , Kohara Kenji , Nakanishi Shuhei , Kaku Kohei , Mune Tomoatsu , Kaneto Hideaki 

TITLE=Case Report: A Variety of Immune-Related Adverse Events Triggered by Immune Checkpoint Inhibitors in a Subject With Malignant Melanoma: Destructive Thyroiditis, Aseptic Meningitis and Isolated ACTH Deficiency

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.722586

DOI=10.3389/fendo.2021.722586

ISSN=1664-2392

ABSTRACT=Recently, immune checkpoint inhibitors have been drawing much attention as cancer immunotherapy, but it has been shown that various immune-related adverse events are induced by immune checkpoint inhibitors in various organs which becomes one of serious issues at present. A 58-year-old Japanese male with malignant melanoma was treated with nivolumab and/or ipilimumab. During the period of treatment, he suffered from various immune-related adverse events. First, about 1 month after starting nivolumab monotherapy, destructive thyroiditis was induced, and then we started replacement therapy with levothyroxine. Second, about 1 month after starting nivolumab and ipilimumab combination therapy, aseptic meningitis was induced. We stopped both drugs and started steroid therapy with prednisolone. Finally, about 9 months after re-starting nivolumab, isolated ACTH deficiency was induced, and then we started replacement therapy with hydrocortisone. Taken together, we should bear in mind the possibility of a variety of immune-related adverse events when we use immune checkpoint inhibitors.