Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

25 January 2019 : Case report  Japan

A Case of Acute Exacerbation of Chronic Adrenal Insufficiency Due to Ipilimumab Treatment for Advanced Melanoma

Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction

Chihiro Sakaguchi1ABCDEF, Seiichi Yano1CDE, Kenji Ashida21ABCDEF*, Naoko Wada3BCDE, Kenji Ohe4ACDE, Hiromi Nagata1DE, Yayoi Matsuda1DE, Shohei Sakamoto1DE, Ryuichi Sakamoto1DE, Keizo Ohnaka5DE, Hiroshi Uchi3DE, Masutaka Furue3DE, Masatoshi Nomura21ACDE, Yoshihiro Ogawa1DE

DOI: 10.12659/AJCR.913021

Am J Case Rep 2019; 20:106-110

Abstract

BACKGROUND: Ipilimumab is a therapeutic human monoclonal antibody that targets the T-cell inhibitory molecule, cytotoxic T-lymphocyte antigen-4 (CTLA-4), and is classified as an immune checkpoint inhibitor that has been shown to improve prognosis in patients with advanced melanoma. However, several immune-related adverse events have been reported to be associated with ipilimumab Treatment. A case of acute exacerbation of chronic adrenal insufficiency is presented that highlights that glucocorticoid dosage for patients undergoing steroid treatment at the time of ipilimumab treatment has yet to be established.

CASE REPORT: A 50-year-old Japanese woman was diagnosed with malignant melanoma on the sole of her right foot. During her second course of ipilimumab treatment, she developed acute adrenal insufficiency caused by isolated adrenocorticotropic hormone (ACTH) deficiency, which required treatment with oral hydrocortisone. However, the symptoms of her adrenal insufficiency worsened, and she commenced treatment with 12 courses of nivolumab, a therapeutic human monoclonal antibody that blocks programmed cell death protein 1 (PD-1) on the surface of T-cells. She did not require corticosteroid support during nivolumab treatment.

CONCLUSIONS: This case report highlights the risk of exacerbating adrenal insufficiency during treatment with ipilimumab. The differences in clinical outcome in this patient between ipilimumab and nivolumab treatment might be explained by the different mechanisms between ipilimumab and nivolumab on immune function.

Keywords: adrenal insufficiency, CTLA-4 Antigen, Glucocorticoids, Programmed Cell Death 1 Receptor

0 Comments

SARS-CoV-2/COVID-19

01 December 2021 : Case report  USA

A 48-Year-Old Immunocompetent Female Resident of Southern Florida with Confirmed Reinfection with P.1 (Gamm...

Am J Case Rep In Press; DOI: 10.12659/AJCR.935329  

26 November 2021 : Case report  Poland

Arteritic Anterior Ischemic Optic Neuropathy in the Course of Giant Cell Arteritis After COVID-19

Am J Case Rep In Press; DOI: 10.12659/AJCR.933471  

01 December 2021 : Case report  USA

Progressive Pulmonary Fibrosis After Non-Critical COVID-19: A Case Report

Am J Case Rep 2021; 22:e933458

25 November 2021 : Case report  USA

A Case of COVID-19-Associated Free-Floating Aortic Thrombus Successfully Treated with Thrombectomy

Am J Case Rep 2021; 22:e933225

In Press

01 Dec 2021 : Case report  USA

A 48-Year-Old Immunocompetent Female Resident of Southern Florida with Confirmed Reinfection with P.1 (Gamm...

Am J Case Rep In Press; DOI: 10.12659/AJCR.935329  

01 Dec 2021 : Case report  Thailand

A 34-Year-Old Thai Man Presenting with Pulmonary Stenosis and Heart Failure 24 Years After Surgical Correct...

Am J Case Rep In Press; DOI: 10.12659/AJCR.933078  

01 Dec 2021 : Case report  USA

Adult-Onset Diamond-Blackfan Anemia with RPL11 Gene Variation Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.932649  

30 Nov 2021 : Case report  USA

Severe Anion Gap Metabolic Acidosis Resulting from Combined Chronic Acetaminophen Toxicity and Starvation K...

Am J Case Rep In Press; DOI: 10.12659/AJCR.934410  

Most Viewed Current Articles

15 Aug 2020 : Case report  USA

A 57-Year-Old African American Man with Severe COVID-19 Pneumonia Who Responded to Supportive Photobiomodul...

DOI :10.12659/AJCR.926779

Am J Case Rep 2020; 21:e926779

09 May 2019 : Case report  USA

A Rare Case of Stage IV Basaloid Squamous Cell Cancer with Intrapulmonary and Brain Metastases

DOI :10.12659/AJCR.915073

Am J Case Rep 2019; 20:664-667

13 Mar 2019 : Case report  USA

Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke’s Encephalopathy...

DOI :10.12659/AJCR.914051

Am J Case Rep 2019; 20:330-334

09 Jan 2019 : Case report  Saudi Arabia

3-M Syndrome: A Local Case Report

DOI :10.12659/AJCR.912736

Am J Case Rep 2019; 20:36-38

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923