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Article in Japanese
A case of isolated adrenocorticotropic hormone deficiency during long-term treatment with an immune checkpoint inhibitor (pembrolizumab)
Hikaru Mamizu Yuhki Sakurai Taishi Yoshioka Takashi Ishida
Department of Internal Medicine, Niigata Prefectural Center Hospital
A 73-year-old man who had been undergoing pembrolizumab treatment for lung adenocarcinoma for more than four years was referred to our hospital due to loss of appetite and fatigue. Blood test results revealed hyponatremia and increased peripheral blood eosinophil counts. A thorough examination led to a diagnosis of isolated adrenocorticotropic hormone deficiency (IAD). Based on the progression of the disease, the IAD was likely a consequence of immune-related adverse events from the pembrolizumab. This highlights the need to always suspect IAD and perform the necessary endocrine evaluations, because IAD may occur even in cases where long-term treatment with immune checkpoint inhibitors appears successful.
Isolated adrenocorticotropic hormone deficiency (IAD) Immune checkpoint inhibitor (ICI) Pembrolizumab Immune-related adverse event (irAE)
Received 9 Jun 2023 / Accepted 17 Aug 2023
AJRS, 12(6): 324-328, 2023