Abstract | BACKGROUND: CASE PRESENTATION: CONCLUSIONS: Our patient developed isolated ACTH deficiency during combination cancer treatment with chemotherapy and sintilimab. Although isolated ACTH deficiency due to anti-PD-1 including sintilimab therapy is rare occurrence, it can often cause severe clinical symptoms. Its diagnosis basically relies on clinical symptoms and endocrinological examination. Unlike traditional hypophysitis diagnosed by cranial MRI, pituitary MRI of IAD due to anti-PD-1 often indicates normal pituitary gland implying that over-reliance on imaging findings is not recommended. Even if clinical symptoms have relieved after corticosteroid replacement therapy was commenced, low levels of ACTH or cortisol could maintain for a long period which highlights the need for long term corticosteroid therapy. The purpose of the current report was to provide increased awareness of early detection and therapy of IAD.
|
Authors | Si-Hong Lin, Ao Zhang, Lu-Zhen Li, Liang-Chen Zhao, Le-Xia Wu, Can-Tu Fang |
Journal | BMC endocrine disorders
(BMC Endocr Disord)
Vol. 22
Issue 1
Pg. 239
(Sep 24 2022)
ISSN: 1472-6823 [Electronic] England |
PMID | 36153581
(Publication Type: Case Reports, Journal Article, Review)
|
Copyright | © 2022. The Author(s). |
Chemical References |
- Antibodies, Monoclonal, Humanized
- Immune Checkpoint Inhibitors
- Pemetrexed
- Estradiol
- sintilimab
- Adrenocorticotropic Hormone
- Follicle Stimulating Hormone
- Hydrocortisone
|
Topics |
- Adenocarcinoma of Lung
(drug therapy)
- Adrenal Insufficiency
- Adrenocorticotropic Hormone
(deficiency)
- Aged
- Antibodies, Monoclonal, Humanized
- Endocrine System Diseases
- Estradiol
- Follicle Stimulating Hormone
- Genetic Diseases, Inborn
- Humans
- Hydrocortisone
- Hypoglycemia
- Immune Checkpoint Inhibitors
- Lung Neoplasms
(complications, drug therapy)
- Male
- Pemetrexed
|