Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, Boston, MA 02114, USA.
Med Oncol. 2012 Mar;29(1):374-7. doi: 10.1007/s12032-010-9794-7. Epub 2011 Jan 25.
A 75-year-old woman with a history of stage IV metastatic melanoma underwent treatment with the CTLA-4 blocking agent Ipilimumab. She presented 2 months after initiating treatment with a severe headache. Laboratories were consistent with severe hyponatremia. MRI of the brain revealed enlargement of the pituitary gland, enhancement of the infundibulum, and an enhancing, centrally necrotic foci in the anterior pituitary. Based on the clinical and radiographic findings, she was diagnosed with treatment-related syndrome of inappropriate antidiuretic hormone secretion (SIADH). Effective treatment consisted of fluid restriction, hyperosmolar therapy, and steroids.
一位 75 岁的女性，患有 IV 期转移性黑色素瘤，接受 CTLA-4 阻断剂 Ipilimumab 治疗。她在开始治疗后 2 个月出现严重头痛。实验室检查符合严重低钠血症。脑 MRI 显示垂体增大，漏斗增强，以及前垂体中央坏死灶增强。根据临床和影像学发现，她被诊断为与治疗相关的抗利尿激素分泌不当综合征（SIADH）。有效的治疗方法包括限制液体摄入、高渗治疗和类固醇治疗。
