RT Journal Article SR Electronic T1 Immune checkpoint inhibitor-mediated hypophysitis: no place like home JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 81 OP 84 DO 10.7861/clinmed.2022-0429 VO 23 IS 1 A1 Tim Cooksley A1 Tom Knight A1 Duncan Lindsay A1 Avinash Gupta A1 Jan Hoong Ho A1 Claire Higham A1 Paul Lorigan A1 Safwaan Adam YR 2023 UL http://www.rcpjournals.org/content/23/1/81.abstract AB Ambulatory emergency care forms a fundamental part of the strategy of trying to ensure safe and sustainable acute care services. Immune checkpoint inhibitor(ICI)-mediated hypophysitis is an important life-threatening complication of therapy. Patients presenting with clinical features and findings consistent with ICI-mediated hypophysitis were considered in the current study. In the absence of severe features (sodium <125 mmol/L, hypotension, reduced consciousness, hypoglycaemia and/or visual field defect), patients were administered a single intravenous dose of hydrocortisone (100 mg), observed for at least 4 h and then discharged on oral hydrocortisone (20 mg, 10 mg and 10 mg). Patients were then seen urgently in the endocrinology outpatient setting for further management. Fourteen patients (median age 64, 10 male) were managed using the pathway. All patients had biochemically confirmed adrenocorticotropic hormone (ACTH) deficiency. Seven of the 14 were treated with combination ICI therapy, with four having pan-anterior hypopituitarism. There were no 30-day readmissions or any associated hypophysitis-related mortality. All patients continued ICI therapy without interruption.