Late Onset Ipilimumab-Induced Pericarditis and Pericardial Effusion: A Rare but Life Threatening Complication

Table 1

Lab values during the hospitalization, baseline TSH, free T4, and cortisol levels were within normal range; however, patient presented with elevated TSH, low free T4, and decreased cortisol levels, suggesting immune-mediated hypothyroidism and adrenal insufficiency.

Labs (reference range)	Baseline	Admission	Day 7 after steroid Tx	Day 21 after steroid Tx	Day 35 after steroid Tx
TSH (0.35–4.00 μIU/mL)	3.26	6.78	8.10	5.85	2.85
Free T4 (0.7–1.5 ng/dL)	0.8	0.4	0.4	1.2	1.0
ACTH (7–69 pg/mL)	NR	NR	<5	<5	<5
Cortisol at 8 AM (4.2–38.4 μg/dL)	10.6	<1.0	<1.0	<1.0	1.5
AST (5–34 IU/L)	28	30	24	18	21
ALT (0–55 IU/L)	13	14	28	33	19
Total bilirubin (0.2–1.2 mg/dL)	1.1	1.9	0.8	0.6	0.6
Troponin I (0.00–0.02 ng/mL)	NR	<0.02	0.07	<0.02	NR