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Related Experiment Video

Updated: Nov 10, 2025

Preparation of Mouse Pituitary Immunogen for the Induction of Experimental Autoimmune Hypophysitis
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Emergency Presentations of Immune Checkpoint Inhibitor-Related Endocrinopathies.

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  • 1The Christie Hospital, Manchester, United Kingdom.

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|April 2, 2021
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Summary

Immune checkpoint inhibitors (ICI) can cause rare but serious immune-mediated endocrinopathies. Early recognition of these toxicities in emergency settings is crucial for patient outcomes.

Keywords:
diabetesemergency oncologyendocrinopathieshypophysitisimmune checkpoint inhibitors

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Area of Science:

  • Oncology
  • Endocrinology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are vital anticancer treatments with increasing use.
  • ICIs can cause immune-mediated toxicities, including endocrinopathies, which present diagnostic challenges due to nonspecific symptoms and potential severity.
  • Prompt recognition of ICI-related endocrinopathies is critical to prevent severe complications.

Purpose of the Study:

  • To investigate the frequency and clinical characteristics of immune-mediated endocrinopathies in patients receiving ICIs who presented to an emergency department.
  • To analyze emergency presentations of immune-related endocrinopathies in patients treated with immune checkpoint inhibitors.

Main Methods:

  • A prospective observational cohort study was conducted at a specialist oncology hospital from May 2018 to May 2020.
  • Patients treated with ICIs presenting to the Oncology Assessment Unit (OAU) were included.
  • The study assessed the incidence of immune-mediated endocrinopathies, length of hospital stay, and 7- and 30-day mortality rates.

Main Results:

  • Out of 684 patients treated with ICIs presenting to the OAU, 24 (3.5%) were diagnosed with acute immune-mediated endocrinopathy.
  • The most common endocrinopathies were hypophysitis (17 patients), diabetes mellitus (4), thyrotoxicosis (2), and adrenalitis (1).
  • Patients with hypophysitis had a median hospital stay of 1 day, and no deaths within 30 days were observed among patients with immune-mediated endocrinopathies.

Conclusions:

  • Acute immune-mediated endocrinopathies are infrequent emergency presentations in patients treated with ICIs.
  • Early identification of immune-mediated toxicities, especially ICI-related endocrinopathies, is essential, as presentations can be vague.
  • Despite potentially life-threatening implications, prompt management in emergency settings appears feasible with good short-term outcomes.