Abdominal pain as an initial symptom of isolated ACTH deficiency induced by nivolumab in a patient with malignant mesothelioma

Used for a wide range of cancers, nivolumab has been reported to cause immune-related adverse events, including isolated adrenocorticotropic hormone deficiency (IAD). We report an 81-year-old woman with malignant mesothelioma who presented with abdominal pain after eight courses of nivolumab therapy...

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Bibliographic Details
Published in:BMJ case reports 2021-07, Vol.14 (7), p.e243093
Main Authors: Hata, Koichi, Sakaguchi, Chikara, Tsuchiya, Michiko, Nagasaka, Yukio
Format: Article
Language:English
Subjects:
Abdomen
Anorexia
Blood pressure
Cancer therapies
Case Report
Case reports
Chemotherapy
Consciousness
Dyspnea
Growth hormones
Head & neck cancer
Hospitals
Hyponatremia
Hypotension
Immunotherapy
Kidney cancer
Lung cancer
Medical imaging
Melanoma
Mesothelioma
Monoclonal antibodies
Nausea
Pain
Patients
Targeted cancer therapy
Thyroid gland
Vomiting
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Summary:Used for a wide range of cancers, nivolumab has been reported to cause immune-related adverse events, including isolated adrenocorticotropic hormone deficiency (IAD). We report an 81-year-old woman with malignant mesothelioma who presented with abdominal pain after eight courses of nivolumab therapy, leading to the diagnosis of nivolumab-induced IAD. We should consider adrenal insufficiency (AI) when a patient on nivolumab complains of abdominal pain and has no other explanatory findings. Infusion-resistant hypotension and hyponatraemia can further suggest AI.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-243093