Patients receiving drugs in the novel class of cancer therapeutics called immune checkpoint inhibitors, have an increased risk for development of autoimmune disorders, including endocrine disorders. Hypophysitis, autoimmune thyroid disease (both hyperthyroidism and hypothyroidism), type 1 diabetes, and primary adrenal insufficiency have been reported (1, 2).
Diagnosis is by measurement of levels of glucose, electrolytes, and hormones as clinically indicated.
Treatment is replacement of hormones documented to be deficient. These might include thyroid hormone, insulin, or glucocorticoids.
1. Ruggeri RM, Campennì A, Giuffrida G, et al: Endocrine and metabolic adverse effects of immune checkpoint inhibitors: an overview (what endocrinologists should know). J Endocrinol Invest Nov. 23, 2018. https://doi.org/10.1007/s40618-018-0984-z
2. Chang L-S, Barroso-Sousa R, Tolaney SM, et al: Endocrine toxicity of cancer immunotherapy targeting immune checkpoints. Endocr Rev 40(1):17–65, 2019. doi: 10.1210/er.2018-00006