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Case Reports
. 2024 Sep 28;16(9):e70401.
doi: 10.7759/cureus.70401. eCollection 2024 Sep.

Gilteritinib-Induced Hypopituitarism: A Case Report

Yuri Hori  1 , Yosuke Okada  1 , Satomi Sonoda  1 , Keiichi Torimoto  1 , Yoshiya Tanaka  1
Affiliations
Case Reports

Gilteritinib-Induced Hypopituitarism: A Case Report

Yuri Hori et al. Cureus. .

Abstract

Gilteritinib is a tyrosine kinase inhibitor (TKI) that treats acute myeloid leukemia (AML) by inhibiting FMS-like tyrosine kinase 3 (FLT3). This is a report on hypopituitarism induced by gilteritinib and its resolution following withdrawal. A 54-year-old woman was treated with gilteritinib for AML. She subsequently developed general fatigue. Blood tests showed low levels of anterior pituitary hormone. After 10 months of gilteritinib withdrawal, the levels of anterior pituitary hormones returned to normal values. When nonspecific symptoms such as fatigue in patients treated with gilteritinib are coupled with electrolyte abnormalities, a close checkup for hypopituitarism is recommended.

Keywords: acute myeloid leukemia; drug withdrawal; gilteritinib; hypopituitarism; pituitary hormone.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. The pituitary MRI images
The patient’s pituitary gland T1WI coronal (A) and axial (B) images and T2WI coronal (C) and axial (D) images are shown. No organic lesions were observed in the pituitary region. T1WI, T1-weighted images; T2WI, T2-weighted images
Figure 2
Figure 2. Results of load test
(A) Results of the CRH load test. The CRH load test showed a normal ACTH response and low cortisol response at six and 10 months of withdrawal. The peak levels of both ACTH and cortisol improved after 10 months of withdrawal compared with those at admission. (B) Results of the GHRP-2 test. The GHRP-2 loading test showed low response, with a GH peak value of <9 ng/mL on admission. GH's response recovered after six months of withdrawal. (C) Results of the LHRH load test. The LH and FSH showed delayed response on admission. Both LH and FSH responses improved after six and 10 months of withdrawal. (D) Results of the TRH load test. The low response was evident in the TRH loading test on admission. TSH response recovered after six and 10 months of withdrawal. GH, growth hormone; FSH, follicle-stimulating hormone; LH, luteinizing hormone; CRH, corticotrophin-releasing hormone; ACTH, adrenocorticotropic hormone; GHRP-2, growth hormone releasing peptide-2; LHRH, luteinizing hormone-releasing hormone
See this image and copyright information in PMC

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