MediAI

Headache and Visual Blurring May Be the First Clues to an Endocrine Immune-Related Adverse Event Headache and blurred vision are common clinical complaints, but their significance changes when they occur in a patient receiving immune checkpoint inhibitor therapy. When new headache, fatigue, nausea, visual symptoms, or unexplained weakness are accompanied by central endocrine abnormalities, immune checkpoint inhibitor-related hypophysitis should be considered. This case describes a man in his late 30s who presented with headache and blurred vision and was found to have central hypothyroidism. A previous noncontrast brain CT showed no obvious abnormality, whereas subsequent pituitary MRI demonstrated enlargement of the pituitary gland and thickening of the pituitary stalk. The clinical history of melanoma and immune checkpoint inhibitor therapy provided a critical diagnostic clue. The key MRI pattern included symmetric pituitary enlargement, pituitary stalk thickening with midline prese...