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Case Reports
. 2019 Dec 1;12(11):e231829.
doi: 10.1136/bcr-2019-231829.

Nivolumab-induced adrenalitis

Iqra Iqbal  1 , Muhammad Atique Alam Khan  1 , Waqas Ullah  2 , Dina Nabwani  3
Affiliations
Case Reports

Nivolumab-induced adrenalitis

Iqra Iqbal et al. BMJ Case Rep. .

Abstract

Immune checkpoint inhibitors (ICIs) are an evolving class of drugs for the treatment of various cancers; for example, their use is recommended as a second-line chemotherapy for non-small cell lung cancer. With the expanding use of ICIs, we are discovering their unique side effects, called immune-related adverse events (irAEs), which can impair gastrointestinal, hepatic, dermatological, endocrine and other systems. Nivolumab is an ICI that blocks the human programmed death receptor-1 (PD-1) on T cells to prevent the interaction between the receptor, PD-1, and human programmed death ligand-1 expressed on tumour cells. Here, we report a case of a 65-year-old woman with recurrent lung adenocarcinoma who was treated with nivolumab and developed immune-related adrenalitis, which was managed with hydrocortisone and fludrocortisone. This case highlights the importance of understanding the irAEs of ICIs to allow prompt recognition and management of life-threatening complications of the treatment.

Keywords: adrenal disorders; chemotherapy; lung cancer (oncology); unwanted effects / adverse reactions.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Primary versus secondary adrenal insufficiency. ACTH, adrenocorticotropic hormone.
See this image and copyright information in PMC

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