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Ipilimumab-Induced Adrenalitis: A Possible Pitfall in 18F-FDG-PET/CT
Open accessAbstract
Ipilimumab is a monoclonal antibody against the inhibitory CTLA-4 receptor expressed on T cells. It provokes an upregulation of the immune system. This substance was approved by the US Food and Drug Administration in 2011 and is since increasingly used as a targeted therapeutic approach for metastasized melanoma. Ipilimumab is known to cause neuroendocrine disorders, such as hypophysitis and adrenal insufficiency. Our case of a 79-year-old patient represents an important imaging pitfall. Imaging findings of newly symmetrically and smoothly enlarged, hypermetabolic adrenal glands in the setting of previous ipilimumab therapy represent drug-induced adrenalitis and not metastatic disease.
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“The plausible mechanisms underlying the development of AI by ICIs are adrenal hypofunction (primary AI) or pituitary ACTH deficiency (secondary AI).”
From The Changing Face of Drug-induced Adrenal Insufficiency in the Food and Drug Administration Adverse Event Reporting System (2022) · cites this paper as [34]
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“Adrenal inflammation highlighted with FDG-PET scan has been reported in several studies with both glands appearing hypermetabolic (34, 35).”
From The Changing Face of Drug-induced Adrenal Insufficiency in the Food and Drug Administration Adverse Event Reporting System (2022) · cites this paper as [34]
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References 16 · Cited by 82
Research works printed but not linked: 14
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Metadata
- Authors
- Bacanovic, S., Burger, I. A., Stolzmann, P., Hafner, J., & Huellner, M. W.
- Affiliations
- University of Zurich (CH)
- University Hospital Zurich (CH)
- Corresponding author
- Bacanovic, Sara
- Burger, Irene A.
- Venue
- Clinical Nuclear Medicine
- Published
- 2015-11
- Volume
- 40
- Issue
- 11
- Pages
- e518-e519
- ISSN
- 0363-9762 (ISSN-L)
- OpenAlex
- W874828184
- Cited by
- 82
- References
- 16
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 6 · 2020: 13 · 2019: 6 · 2018: 13 · 2017: 11 · 2016: 5
- FWCI
- 8.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.zora.uzh.ch
- Licence
- other-oa
- Locations
- Clinical Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- ipilimumab, adrenal insufficiency, CTLA-4, immune checkpoint inhibitors, melanoma, adrenal enlargement
- MeSH terms
- Ipilimumab, Adrenocortical Hyperfunction, Aged, Antibodies, Monoclonal, Antineoplastic Agents, False Positive Reactions, Humans, Male, Melanoma, Neoplasm Metastasis, Tomography, X-Ray Computed, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography, Multimodal Imaging
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