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Cytotoxic T-lymphocyte-associated Antigen-4 Blockage Can Induce Autoimmune Hypophysitis In Patients With Metastatic Melanoma And Renal Cancer.

J. Blansfield, Kimberly E. Beck, K. Tran, J. Yang, M. Hughes, U. Kammula, R. Royal, S. Topalian, Leah R. Haworth, C. Levy, S. Rosenberg, R. Sherry
Published 2005 · Medicine

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Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) is an immunoregulatory molecule expressed by activated T cells and resting CD4CD25 T cells. In patients with advanced melanoma, our group reported that administration of anti-CTLA-4 antibody mediated objective cancer regression in 13% of patients. This study also established that the blockade of CTLA-4 was associated with grade III/IV autoimmune manifestations that included dermatitis, enterocolitis, hepatitis, uveitis, and a single case of hypophysitis. Since this initial report, 7 additional patients with anti-CTLA-4 antibody-induced autoimmune hypophysitis have been accumulated. The characteristics, clinical course, laboratory values, radiographic findings, and treatment of these 8 patients are the focus of this report.
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