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Isolated adrenocorticotropic hormone deficiency due to pembrolizumab in a case of lung squamous cell carcinoma
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- Sasaki Hisashi
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Miyata Jun
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Nishimura Masashi
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Maki Yohei
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Tagami Yoichi
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Hamakawa Yusuke
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Kimizuka Yoshifumi
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Hayashi Nobuyoshi
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Fujikura Yuji
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
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- Kawana Akihiko
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College
Bibliographic Information
- Other Title
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- 【投稿/症例報告】ペムブロリズマブ投与後にACTH単独欠損症を来した肺扁平上皮癌の1例
Description
A-60-year-old man presented with right cervical lymphadenopathy. Histological analysis of the lymph node demonstrated metastasis of squamous-cell-carcinoma. Chest computed tomography (CT) showed a pulmonary tumor lesion at the right upper lobe (S1). Thus, diagnosis of lung squamous cell carcinoma (cT2aN3M1c, stage Ⅳ B (LYM, OSS)) was determined. Immunostaining of the tumor revealed PD-L1 of >50% cancer cells was positive. Pembrolizumab (200 mg/body every 3 weeks) was introduced as first-line therapy. After 5 times of administration, he presented with physical weariness. Laboratory data of peripheral blood showed an elevated proportion of eosinophils and undetectable levels of both cortisol and adrenocorticotropic hormone (ACTH). Basal concentrations of other endocrine hormones were within normal range. High-dose ACTH stimulation test revealed a poor response of cortisol secretion, indicative of secondary adrenal cortical insufficiency. No metastatic and/or primary lesions of pituitary gland and bilateral adrenal glands were found upon examinations of head magnetic resonance imaging and abdominal CT. Finally, diagnosis of isolated ACTH deficiency due to pembro-lizumab was confirmed.
Journal
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- Japanese Open Journal of Respiratory Medicine
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Japanese Open Journal of Respiratory Medicine 3 (12), n/a-, 2019
COSMIC
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Keywords
Details 詳細情報について
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- CRID
- 1390575340759061760
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- ISSN
- 24333778
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- Text Lang
- ja
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- Data Source
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- JaLC
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- Abstract License Flag
- Allowed