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  1. C100 医学部/医学系研究科
  2. C100b 紀要
  3. Nagoya journal of medical science
  4. 80(2)

Refractory hypotension due to Nivolumab-induced adrenal insufficiency

https://doi.org/10.18999/nagjms.80.2.285
https://doi.org/10.18999/nagjms.80.2.285
d55b9e93-22d3-449a-b3eb-8c9a4375b89f
名前 / ファイル ライセンス アクション
15_Tsukizawa.pdf 15_Tsukizawa.pdf (251.6 kB)
Item type 紀要論文 / Departmental Bulletin Paper(1)
公開日 2018-05-28
タイトル
タイトル Refractory hypotension due to Nivolumab-induced adrenal insufficiency
著者 Tsukizawa, Yoshiaki

× Tsukizawa, Yoshiaki

WEKO 77361

Tsukizawa, Yoshiaki

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Kondo, Keisuke

× Kondo, Keisuke

WEKO 77362

Kondo, Keisuke

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Ichiba, Toshihisa

× Ichiba, Toshihisa

WEKO 77363

Ichiba, Toshihisa

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Naito, Hiroshi

× Naito, Hiroshi

WEKO 77364

Naito, Hiroshi

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Mizuki, Kazuhito

× Mizuki, Kazuhito

WEKO 77365

Mizuki, Kazuhito

Search repository
Masuda, Ken

× Masuda, Ken

WEKO 77366

Masuda, Ken

Search repository
キーワード
主題Scheme Other
主題 adrenal insufficiency
キーワード
主題Scheme Other
主題 hypotension
キーワード
主題Scheme Other
主題 immune checkpoint inhibitor
抄録
内容記述 Nivolumab, a new immune checkpoint inhibitor that has been found to improve outcomes for patients with some advanced cancers, is being increasingly used. Immune checkpoint inhibitors can cause immune- related adverse events, including dermatitis, enterocolitis, hepatitis and hypophysitis, but adrenal insufficiency rarely occurs. We present a case of Nivolumab-induced adrenal insufficiency in a man who complained of refractory hypotension. A 52-year-old man with non-small cell lung cancer visited our emergency depart- ment complaining of fatigue and diarrhea. He had received Nivolumab every 2 weeks as third-line therapy for a total of 10 times. On arrival, his vital signs revealed shock: blood pressure, 68/48 mmHg; heart rate, 141 beats per minutes. Laboratory examination showed severe hemoconcentration with a hemoglobin level of 19.9 g/dL, normal electrolyte levels and hyperglycemia. We started intravenous infusion of 4.5 L of extracellular fluid, but his vital signs remained unstable. After admission, endocrine examination revealed abnormally low values of serum cortisol (4.86 μg/dL) and ACTH (<1.0 pg/mL), which had been normal at 2 months before admission (21.14 μg/dL and 20.1 pg/mL, respectively). We therefore made a diagnosis of adrenal insufficiency induced by Nivolumab and administered 100 mg hydrocortisone succinate sodium intravenously. He recovered soon after hydrocortisone replacement therapy. Nivolumab is a new immune checkpoint inhibitor and general physicians are not familiar with it. However, adverse events caused by Nivolumab, especially adrenal insufficiency, can lead to serious adverse outcomes if overlooked. We should recognize Nivolumab-induced adrenal insufficiency and administer a glucocorticoid immediately in cancer patients treated with immune checkpoint inhibitors.
内容記述タイプ Abstract
出版者
出版者 Nagoya University Graduate School of Medicine, School of Medicine
言語
言語 eng
資源タイプ
資源 http://purl.org/coar/resource_type/c_6501
タイプ departmental bulletin paper
ID登録
ID登録 10.18999/nagjms.80.2.285
ID登録タイプ JaLC
関連情報
関連タイプ isVersionOf
識別子タイプ URI
関連識別子 http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/802.html
ISSN(print)
収録物識別子タイプ ISSN
収録物識別子 0027-7622
書誌情報 Nagoya Journal of Medical Science

巻 80, 号 2, p. 285-288, 発行日 2018-05
著者版フラグ
値 publisher
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