CTLA4 and isolated hemihyperplasia: Specifically, about IH, there are two distinct patterns of presentation: a lymphocytic hypophysitis-like condition with pituitary enlargement and multiple hormone deficiencies in those treated with anti-CTLA-4 agents/combination CTLA-4/PD-1 therapy; isolated ACTH deficiency in those treated with anti- PD-1 agents [82].