❖ Diagnosis: Complete blood count, comprehensive metabolic profile. Consult endocrineThyroiditis: TSH. If TSH is below 0.5 × ULN or above 2 × ULN or consistently out of normal range in subsequent cycles consider adding free T3 and T4.Adrenalitis: ACTH, Morning serum cortisol-if abnormal Cosyntropin stimulation test.Hypophysitis: LH/FSH/Testosterone, Prolactin. MRI brain with pituitary cuts and visual field testing if indicated.❖ Treatment: Continue immunotherapy.Monitor for symptoms. If worsens treat as higher grades.Treat for hyper or hypothyroidism if indicated. The gene discussed is PLOD1; the disease is hypophysitis.