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Progression of Hypopituitarism and Hypothyroidism after Treatment with Pembrolizumab in a Patient with Adrenal Metastasis from Non-small-cell Lung Cancer
- Source :
- Internal Medicine
- Publication Year :
- 2019
- Publisher :
- Japanese Society of Internal Medicine, 2019.
-
Abstract
- Pembrolizumab, or anti-programmed death receptor 1 antibody, is an immune checkpoint inhibitor that can cause immune-related adverse events. We herein report for the first time the progression of hypopituitarism and hypothyroidism after treatment with pembrolizumab in a patient with adrenal metastasis of non-small-cell lung cancer. Severe primary hypothyroidism occurred three weeks after the first administration of pembrolizumab. Four months after the discontinuation of pembrolizumab, isolated adrenocorticotropic hormone (ACTH) deficiency was noted. Corticotropin-releasing hormone and rapid ACTH tests performed repeatedly showed that the patient's pituitary and adrenal function had been gradually deteriorating. It is important to diagnose adrenal insufficiency without delay in order to prevent adrenal crisis.
- Subjects :
- Male
endocrine system
medicine.medical_specialty
Lung Neoplasms
Corticotropin-Releasing Hormone
Adrenal Gland Neoplasms
Case Report
Adrenocorticotropic hormone
Pembrolizumab
Hypopituitarism
030204 cardiovascular system & hematology
Antibodies, Monoclonal, Humanized
Gastroenterology
03 medical and health sciences
Antineoplastic Agents, Immunological
0302 clinical medicine
Adrenocorticotropic Hormone
Hypothyroidism
Carcinoma, Non-Small-Cell Lung
Internal medicine
Internal Medicine
medicine
Adrenal insufficiency
Humans
Lung cancer
business.industry
Primary hypothyroidism
Adrenal crisis
General Medicine
medicine.disease
Discontinuation
Disease Progression
immune-related adverse events
030211 gastroenterology & hepatology
pembrolizumab
medicine.symptom
business
hormones, hormone substitutes, and hormone antagonists
Adrenal Insufficiency
Subjects
Details
- ISSN :
- 13497235 and 09182918
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- Internal Medicine
- Accession number :
- edsair.doi.dedup.....4978a9f2a9c1081dbe11ae9d2025ef09