• Tim Cooksley, Tom Knight, Avinash Gupta, Claire Higham, Paul Lorigan, and Safwaan Adam.
• Department of Acute Medicine and Critical Care, The Christie, Wilmslow Road, Manchester, UK. cooks199@hotmail.com.
• Support Care Cancer. 2020 Sep 1; 28 (9): 3995-3999.

PurposeImmune-mediated hypophysitis is an important toxicity related to immune checkpoint inhibitors (ICI). Optimal management is associated with improved outcomes. It represents a wide spectrum of clinical presentations, and a proportion may be suitable for emergency ambulatory management.MethodsEmergency ambulatory management of patients presenting with clinical features and findings consistent with ICI-induced hypophysitis was considered at a tertiary cancer/endocrinology hospital. Suitable patients were initially investigated and treated in accordance with the UK emergency management guidelines for ICI induced hypophysitis. After an initial observation period of 4 h, patients were discharged with oral hydrocortisone (20, 10, 10 mg).ResultsAn initial cohort of 4 patients with emergency presentations of ICI-induced hypophysitis has been managed in an ambulatory fashion in the first 3 months. There were no 30-day readmissions.ConclusionCarefully selected emergency presentations with immune-mediated hypophysitis may be suitable for ambulatory management.

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