A patient on immunotherapy develops immune-related hypophysitis with secondary adrenal insufficiency and central hypothyroidism. Both cortisol and

Question

A patient on immunotherapy develops immune-related hypophysitis with secondary adrenal insufficiency and central hypothyroidism. Both cortisol and TSH are low. In what order should hormone replacement be initiated?

Accepted Answer

Start hydrocortisone first, then levothyroxine after cortisol replacement is established

Answer

Start levothyroxine first, then hydrocortisone as the preferred next step

Answer

Start neither as the preferred next management strategy in this patient

Answer

Only replace cortisol as the preferred next management strategy in this patient

Answer

Start both simultaneously as the preferred next management strategy in this patient

irAE Hypophysitis — SCE Medical Oncology MCQ

A patient on immunotherapy develops immune-related hypophysitis with secondary adrenal insufficiency and central hypothyroidism. Both cortisol and TSH are low. In what order should hormone replacement be initiated?