Background: Immunotherapy-associated hypophysitis is an uncommon adverse event. However, if not handled properly, it could lead to fatal sequelae. Case description: Case 1. A 66-year-old man presented to our hospital with hyponatremia. He had low plasma levels of adrenocorticotropin and cortisol. The patient had a history of non-small cell lung cancer and had undergone 16 cycles of immunotherapy with sintilimab, a monoclonal antibody against programmed cell death protein 1 (PD1). He was diagnosed with adrenal insufficiency secondary to immunotherapy-associated hypophysitis and received a physiological dose of glucocorticoids. Upon discharge, he has prescribed a continued course of hormone replacement therapy combined with immunotherapy—case 2. The second case profiled here involved a 58-year-old patient diagnosed with gastric antrum cancer. After ten months of immunotherapy with carrelizumab, a human high-affinity immunoglobulin G4 (IgG4) anti-PD-1 monoclonal antibody drug, the patient was referred to the Endocrinology Department at our medical centre for adrenal nodules and intolerance of anorexia. He also suffered from hypophysitis and was prescribed hormone replacement therapy combined with immunotherapy. Conclusions: This article discusses the clinical characteristics, diagnosis, treatment, and subsequent follow-up for immunotherapy-associated hypophysitis in the context of two case reports. Based on our findings and observations, we conclude that patients with immunotherapy should regularly be referred to endocrine-related follow-up during tumour treatment.

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抗 PD1 治疗下的免疫治疗相关性垂体炎：两例报告

背景：免疫治疗相关的垂体炎是一种罕见的不良事件。但是，如果处理不当，可能会导致致命的后遗症。病例描述： 病例 1. 一名 66 岁男性因低钠血症就诊于我院。他的血浆促肾上腺皮质激素和皮质醇水平较低。该患者有非小细胞肺癌病史，并接受了 16 个周期的免疫治疗，信迪利单抗是一种针对程序性细胞死亡蛋白 1 (PD1) 的单克隆抗体。他被诊断为继发于免疫治疗相关性垂体炎的肾上腺功能不全，并接受了生理剂量的糖皮质激素治疗。出院后，他开了一个持续的激素替代疗法结合免疫疗法的疗程——案例 2。此处描述的第二个案例涉及一名被诊断患有胃窦癌的 58 岁患者。在使用卡瑞利珠单抗（一种人高亲和力免疫球蛋白 G4 (IgG4) 抗 PD-1 单克隆抗体药物）进行十个月的免疫治疗后，该患者因肾上腺结节和厌食不耐受被转诊至我们医疗中心的内分泌科。他还患有垂体炎，并接受了激素替代疗法和免疫疗法相结合的治疗。结论：本文结合两例病例报告讨论了免疫治疗相关垂体炎的临床特征、诊断、治疗和后续随访。根据我们的发现和观察，我们得出结论，接受免疫治疗的患者在肿瘤治疗期间应定期接受内分泌相关的随访。一种人高亲和力免疫球蛋白 G4 (IgG4) 抗 PD-1 单克隆抗体药物，患者因肾上腺结节和厌食不耐受被转诊至我们医疗中心的内分泌科。他还患有垂体炎，并接受了激素替代疗法和免疫疗法相结合的治疗。结论：本文结合两例病例报告讨论了免疫治疗相关垂体炎的临床特征、诊断、治疗和后续随访。根据我们的发现和观察，我们得出结论，接受免疫治疗的患者在肿瘤治疗期间应定期接受内分泌相关的随访。一种人高亲和力免疫球蛋白 G4 (IgG4) 抗 PD-1 单克隆抗体药物，患者因肾上腺结节和厌食不耐受被转诊至我们医疗中心的内分泌科。他还患有垂体炎，并接受了激素替代疗法和免疫疗法相结合的治疗。结论：本文结合两例病例报告讨论了免疫治疗相关垂体炎的临床特征、诊断、治疗和后续随访。根据我们的发现和观察，我们得出结论，接受免疫治疗的患者在肿瘤治疗期间应定期接受内分泌相关的随访。他还患有垂体炎，并接受了激素替代疗法和免疫疗法相结合的治疗。结论：本文结合两例病例报告讨论了免疫治疗相关垂体炎的临床特征、诊断、治疗和后续随访。根据我们的发现和观察，我们得出结论，接受免疫治疗的患者在肿瘤治疗期间应定期接受内分泌相关的随访。他还患有垂体炎，并接受了激素替代疗法和免疫疗法相结合的治疗。结论：本文结合两例病例报告讨论了免疫治疗相关垂体炎的临床特征、诊断、治疗和后续随访。根据我们的发现和观察，我们得出结论，接受免疫治疗的患者在肿瘤治疗期间应定期接受内分泌相关的随访。