Clinical Practice and Cases in Emergency Medicine (Aug 2024)

Immune Checkpoint Inhibitor-Induced Primary Adrenal Insufficiency: A Case Report

  • Rahul Gupta,
  • Cary Lubkin

DOI
https://doi.org/10.5811/cpcem.20448
Journal volume & issue
Vol. 8, no. 4
pp. 339 – 342

Abstract

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Introduction: One of the less common and more life-threatening etiologies of adrenal insufficiency is immune checkpoint inhibitor (ICI)-induced primary adrenal insufficiency (PAI). Patients typically present with fatigue, malaise, and nausea and are treated empirically with hydrocortisone. Case Report: We present the case of a 59-year-old female who presented with hypotension, which initially was thought to be due to hypovolemia or medication-related, but was ultimately found to have PAI. Conclusion: This case highlights the importance of early detection of ICI-induced primary adrenal insufficiency, given its associated morbidity and mortality and its incidence in patients with a history of immunotherapy.