The Experts below are selected from a list of 396 Experts worldwide ranked by ideXlab platform
N Sato - One of the best experts on this subject based on the ideXlab platform.
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mri findings of immune checkpoint inhibitor induced hypophysitis possible association with fibrosis
American Journal of Neuroradiology, 2020Co-Authors: Ryo Kurokawa, Y Ota, Wataru Gonoi, Akifumi Hagiwara, Mariko Kurokawa, Harushi Mori, Eriko Maeda, Shiori Amemiya, Yukiko Usui, N SatoAbstract:BACKGROUND AND PURPOSE: Hypophysitis is one of the well-known adverse effects of immune checkpoint inhibitors. Immune checkpoint inhibitor–induced hypophysitis frequently causes irreversible hypopituitarism, which requires long-term hormone replacement. Despite the high frequency and clinical significance, characteristic MR imaging findings of immune checkpoint inhibitor–induced hypophysitis have not been established. In the present study, we aimed to review and extract the MR imaging features of immune checkpoint inhibitor–induced hypophysitis. MATERIALS AND METHODS: This retrospective international multicenter study comprised 20 patients with melanoma who were being treated with immune checkpoint inhibitors and clinically diagnosed with immune checkpoint inhibitor–induced hypophysitis. Three radiologists evaluated the following MR imaging findings: enlargement of the pituitary gland and stalk; homogeneity of enhancement of the pituitary gland; presence/absence of a well-defined poorly enhanced area and, if present, its location, shape, and signal intensity in T2WI; and enhancement pattern in contrast-enhanced dynamic MR imaging. Clinical symptoms and hormone levels were also recorded. RESULTS: Enlargement of the pituitary gland and stalk was observed in 12 and 20 patients, respectively. Nineteen patients showed poorly enhanced lesions (geographic hypoenhancing lesions) in the anterior lobe, and 11 of these lesions showed hypointensity on T2WI. Thyrotropin Deficiency and Corticotropin Deficiency were observed in 19/20 and 12/17 patients, respectively, which persisted in 12/19 and 10/12 patients, respectively, throughout the study period. CONCLUSIONS: Pituitary geographic hypoenhancing lesions in the anterior lobe of the pituitary gland are characteristic and frequent MR imaging findings of immune checkpoint inhibitor–induced hypophysitis. They reflect fibrosis and are useful in distinguishing immune checkpoint inhibitor–induced hypophysitis from other types of hypophysitis/tumors.
Beverly M K Biller - One of the best experts on this subject based on the ideXlab platform.
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unreplaced sex steroid Deficiency Corticotropin Deficiency and lower igf i are associated with lower bone mineral density in adults with growth hormone Deficiency a kims database analysis
The Journal of Clinical Endocrinology and Metabolism, 2011Co-Authors: Nicholas A Tritos, Susan L Greenspan, Donna King, Amir H Hamrahian, David M Cook, Peter Jonsson, Michael Wajnrajch, Maria Koltowskahaggstrom, Beverly M K BillerAbstract:Lower bone density in GH-deficient adults is associated with lower IGF-1 SD scores, unreplaced sex steroid Deficiency, and Corticotropin Deficiency.
Thierry Brue - One of the best experts on this subject based on the ideXlab platform.
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management of endocrine disease immune check point inhibitors induced hypophysitis
European Journal of Endocrinology, 2019Co-Authors: Frederique Albarel, Frederic Castinetti, Thierry BrueAbstract:In recent years, the development of immunotherapy has constituted a revolution in the therapy for many cancers, with a specific toxicity profile including endocrine immune-related adverse events. Immune check point inhibitors (ICI)-induced hypophysitis is a common endocrine side effect, particularly with CTLA-4 antibodies and combination therapy, with frequent hormonal deficiencies at diagnosis. It can be difficult to evoke such diagnosis as the initial clinical symptoms are not specific (headache, asthenia…); thus, patients receiving such immunomodulatory therapies should be closely monitored by systematic hormone measurements, especially in the first weeks of treatment. Usually, hormonal deficiencies improve, except for corticotroph function. Despite a lack of large prospective studies on ICI-induced hypophysitis, some detailed longitudinal cohort studies have focused on such cases of hypophysitis and allow for optimal monitoring, follow-up and management of patients with this immune-related adverse event. In the case of ICI-induced hypophysitis, patients need long-term multidisciplinary follow-up, with specific education for those patients with Corticotropin Deficiency to allow them to be autonomous with their treatment. In this review, based on a clinical case, we detail the most relevant and novel aspects related to the incidence, diagnosis, treatment, evolution and management of hypophysitis induced by immunotherapy, with a focus on possible mechanisms and current recommendations and guidelines. Lastly, we emphasize several key points, such as the absence of indication to systematically treat with high-dose glucocorticoid and the pursuit of immunotherapy in such hypophysitis. These points should be kept in mind by oncologists and endocrinologists who treat and monitor patients treated by immunotherapy.
Ryo Kurokawa - One of the best experts on this subject based on the ideXlab platform.
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mri findings of immune checkpoint inhibitor induced hypophysitis possible association with fibrosis
American Journal of Neuroradiology, 2020Co-Authors: Ryo Kurokawa, Y Ota, Wataru Gonoi, Akifumi Hagiwara, Mariko Kurokawa, Harushi Mori, Eriko Maeda, Shiori Amemiya, Yukiko Usui, N SatoAbstract:BACKGROUND AND PURPOSE: Hypophysitis is one of the well-known adverse effects of immune checkpoint inhibitors. Immune checkpoint inhibitor–induced hypophysitis frequently causes irreversible hypopituitarism, which requires long-term hormone replacement. Despite the high frequency and clinical significance, characteristic MR imaging findings of immune checkpoint inhibitor–induced hypophysitis have not been established. In the present study, we aimed to review and extract the MR imaging features of immune checkpoint inhibitor–induced hypophysitis. MATERIALS AND METHODS: This retrospective international multicenter study comprised 20 patients with melanoma who were being treated with immune checkpoint inhibitors and clinically diagnosed with immune checkpoint inhibitor–induced hypophysitis. Three radiologists evaluated the following MR imaging findings: enlargement of the pituitary gland and stalk; homogeneity of enhancement of the pituitary gland; presence/absence of a well-defined poorly enhanced area and, if present, its location, shape, and signal intensity in T2WI; and enhancement pattern in contrast-enhanced dynamic MR imaging. Clinical symptoms and hormone levels were also recorded. RESULTS: Enlargement of the pituitary gland and stalk was observed in 12 and 20 patients, respectively. Nineteen patients showed poorly enhanced lesions (geographic hypoenhancing lesions) in the anterior lobe, and 11 of these lesions showed hypointensity on T2WI. Thyrotropin Deficiency and Corticotropin Deficiency were observed in 19/20 and 12/17 patients, respectively, which persisted in 12/19 and 10/12 patients, respectively, throughout the study period. CONCLUSIONS: Pituitary geographic hypoenhancing lesions in the anterior lobe of the pituitary gland are characteristic and frequent MR imaging findings of immune checkpoint inhibitor–induced hypophysitis. They reflect fibrosis and are useful in distinguishing immune checkpoint inhibitor–induced hypophysitis from other types of hypophysitis/tumors.
Nicholas A Tritos - One of the best experts on this subject based on the ideXlab platform.
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unreplaced sex steroid Deficiency Corticotropin Deficiency and lower igf i are associated with lower bone mineral density in adults with growth hormone Deficiency a kims database analysis
The Journal of Clinical Endocrinology and Metabolism, 2011Co-Authors: Nicholas A Tritos, Susan L Greenspan, Donna King, Amir H Hamrahian, David M Cook, Peter Jonsson, Michael Wajnrajch, Maria Koltowskahaggstrom, Beverly M K BillerAbstract:Lower bone density in GH-deficient adults is associated with lower IGF-1 SD scores, unreplaced sex steroid Deficiency, and Corticotropin Deficiency.
