One case of primary adrenal insufficiency induced by pembrolizumab

doi:10.19803/j.1672-8629.2021.12.24

Abstract

Abstract: Objective To investigate the pathogenesis and management of primary adrenal insufficiency caused by pembrolizumab. Methods The diagnosis and treatment process of one case with primary adrenal insufficiency caused by pembrolizumab was analyzed. Based on literature analysis, the causal relationships between pembrolizumab and primary adrenal insufficiency, incidence, pathogenesis and treatments were explored. Results After 6 months of intravenous administration of pembrolizumab, the patient showed obvious symptoms of fatigue, poor physical strength, poor appetite and blackened skin. The patient was hospitalized for laboratory examination of 8AM serum ACTH 16.7 pmol·L^-1 and 8AM serum cortisol < 25.7 nmol·L^-1. Primary adrenal insufficiency caused by pembrolizumab was suspected. It was recommended that pembrolizumab be suspended, and that oral prednisone (5 mg·time^-1, bid) was used as an alternative therapy with steroid hormone. The patient's symptoms improved after one week and he was discharged. The dosage of prednisone was gradually reduced to 5 mg·d^-1. Conclusion Primary adrenal insufficiency caused by pembrolizumab should be treated according to the classification standards for adverse reactions.

Key words: pembrolizumab, primary adrenal insufficiency, adverse drug reaction

CLC Number:

R969.3

MENG Dehui, WANG Weilan. One case of primary adrenal insufficiency induced by pembrolizumab[J]. Chinese Journal of Pharmacovigilance, 2022, 19(1): 107-110.

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