[A Case of Nivolumab-Induced Isolated Adrenocorticotropic Hormone Deficiency Presenting Dyspnea]

Hinyokika Kiyo. 2018 Oct;64(10):391-395. doi: 10.14989/ActaUrolJap_64_10_391.
[Article in Japanese]

Abstract

A 66-year-old man had undergone multiple treatments for metastatic renal cell carcinoma, including 11 cycles of nivolumab, which was discontinued because of disease progression. About three weeks after discontinuing nivolumab, he reported suffering from worsening of dyspnea. Pulse oximetry showed no desaturation. His cardiovascular and pulmonary functions were normal. His dyspnea slowly worsened with no underlying diagnosis. Two months after symptoms developed, he was diagnosed with isolated adrenocorticotropic hormone deficiency. His dyspnea disappeared soon after receiving hydrocortisone. Nivolumab-induced isolated adrenocorticotropic hormone deficiency may not present with typical symptoms, and can occur even after discontinuing nivolumab. Cortisol levels should be routinely monitored in patients who receive nivolumab.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Insufficiency / chemically induced*
  • Aged
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / surgery
  • Dyspnea / chemically induced*
  • Humans
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery
  • Male
  • Nivolumab / adverse effects*
  • Nivolumab / therapeutic use

Substances

  • Antineoplastic Agents, Immunological
  • Nivolumab

Supplementary concepts

  • Adrenocorticotropic hormone deficiency