Clin Pract Cases Emerg Med
Cooper University Hospital, Department of Emergency Medicine, Camden, New Jersey.
Published: November 2024
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.
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http://dx.doi.org/10.5811/cpcem.20448 | DOI Listing |
Leg Med (Tokyo)
January 2025
University of Modena and Reggio Emilia, Italy. Electronic address:
Waterhouse-Friderichsen Syndrome (WFS) is a rare but life-threatening condition characterized by massive adrenal hemorrhage. WFS represents one of the features of the Overwhelming Post-Splenectomy Infection, which occurs any time after spleen removal and is recognized as the most serious complication in asplenic patients. We report a fatal case of WFS resulting from Streptococcus pneumoniae infection in a vaccinated and splenectomized patient.
View Article and Find Full Text PDFZhong Nan Da Xue Xue Bao Yi Xue Ban
July 2024
Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China.
Immune checkpoint inhibitors (ICPis) significantly improves survival in a number of cancer patients by blocking immunosuppressive molecules and reactivating the function of effector T cells to specifically kil tumor cells. This article reports a case of secondary hypoadrenocorticism caused by programmed death 1 (PD-1) inhibitor related hypophysitis. A 65-year-old male patient received immunotherapy for right lung squamous cell carcinoma invading the chest wall (cT4N2M0) for 4 times.
View Article and Find Full Text PDFJ Pediatr Endocrinol Metab
January 2025
Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Türkiye.
Objectives: Premature ovarian insufficiency (POI) affects 1 in 10,000 children, with its molecular causes largely unknown. Adult studies suggest that low androgen levels induce ovarian insufficiency, but data on about this in children is limited. This study aims to assess the prevalence of low androgen levels in childhood POI and its relationship with adrenal insufficiency.
View Article and Find Full Text PDFJTCVS Open
December 2024
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
Objective: Previous retrospective studies have established a relationship between postoperative hypoglycemia and adverse outcomes after cardiac surgery, but none have accounted for the cause of hypoglycemia.
Methods: A retrospective review was performed of patients who underwent cardiac surgery at a single institution between 2016 and 2021. Patients were categorized as hypoglycemic if they had 1 or more postoperative blood glucose measurement less than 70 mg/dL and normoglycemic otherwise.
Nat Rev Endocrinol
January 2025
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Immune-related adverse events (irAEs), including endocrine irAEs, can occur in response to cancer immunotherapy using immune checkpoint inhibitors (ICIs). Of the endocrine irAEs, pituitary and thyroid irAEs are most frequently observed, followed by primary adrenal insufficiency, type 1 diabetes mellitus and hypoparathyroidism. Notably, pituitary irAEs and type 1 diabetes mellitus can be lethal if overlooked, potentially leading to adrenal crisis and diabetic ketoacidosis, respectively.
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