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本文引用的文献

1
Primary adrenal insufficiency induced by immune checkpoint inhibitors: biological, clinical, and radiological aspects.免疫检查点抑制剂所致原发性肾上腺功能不全：生物学、临床和影像学方面。
Semin Oncol. 2023 Dec;50(6):144-148. doi: 10.1053/j.seminoncol.2023.11.003. Epub 2023 Dec 6.
2
Immune checkpoint inhibitor-associated new-onset primary adrenal insufficiency: a retrospective analysis using the FAERS.免疫检查点抑制剂相关的新发原发性肾上腺功能不全：使用 FAERS 的回顾性分析。
J Endocrinol Invest. 2022 Nov;45(11):2131-2137. doi: 10.1007/s40618-022-01845-z. Epub 2022 Jul 23.
3
Immune checkpoint inhibitors and adrenal insufficiency: a large-sample case series study.免疫检查点抑制剂与肾上腺功能不全：一项大样本病例系列研究。
Ann Transl Med. 2022 Mar;10(5):251. doi: 10.21037/atm-21-7006.
4
Endocrine toxicities of immune checkpoint inhibitors.免疫检查点抑制剂的内分泌毒性。
Nat Rev Endocrinol. 2021 Jul;17(7):389-399. doi: 10.1038/s41574-021-00484-3. Epub 2021 Apr 19.
5
Immune Checkpoint Inhibitor-Related Adrenal Insufficiency.免疫检查点抑制剂相关的肾上腺功能不全。
Semin Oncol Nurs. 2021 Apr;37(2):151131. doi: 10.1016/j.soncn.2021.151131. Epub 2021 Mar 28.
6
Immune Checkpoint Inhibitor-Induced Adrenalitis and Primary Adrenal Insufficiency: Systematic Review and Optimal Management.免疫检查点抑制剂相关性肾上腺炎和原发性肾上腺功能不全：系统评价和最佳治疗方法。
Endocr Pract. 2021 Feb;27(2):165-169. doi: 10.1016/j.eprac.2020.09.016. Epub 2020 Dec 16.
7
Management of endocrine immune-related adverse events of immune checkpoint inhibitors: an updated review.免疫检查点抑制剂内分泌免疫相关不良事件的管理：最新综述
Endocr Connect. 2020 Oct;9(10):R207-R228. doi: 10.1530/EC-20-0342.
8
Primary Adrenal Insufficiency during Immune Checkpoint Inhibitor Treatment: Case Reports and Review of the Literature.免疫检查点抑制剂治疗期间的原发性肾上腺功能不全：病例报告及文献综述
Case Rep Oncol. 2020 Jun 9;13(2):621-626. doi: 10.1159/000507652. eCollection 2020 May-Aug.
9
Immune Checkpoint Inhibitor-Associated Primary Adrenal Insufficiency: WHO VigiBase Report Analysis.免疫检查点抑制剂相关原发性肾上腺功能不全：WHO VigiBase 报告分析。
Oncologist. 2020 Aug;25(8):696-701. doi: 10.1634/theoncologist.2019-0555. Epub 2020 May 17.
10
Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports.癌症患者中免疫检查点抑制剂诱发的内分泌病谱：病例报告的范围综述
Clin Diabetes Endocrinol. 2019 Jan 22;5:1. doi: 10.1186/s40842-018-0073-4. eCollection 2019.

免疫检查点抑制剂诱导的原发性肾上腺皮质功能减退：一例报告

Immune Checkpoint Inhibitor-Induced Primary Adrenal Insufficiency: A Case Report.

作者信息

Gupta Rahul, Lubkin Cary

机构信息

Cooper University Hospital, Department of Emergency Medicine, Camden, New Jersey.

出版信息

Clin Pract Cases Emerg Med. 2024 Nov;8(4):339-342. doi: 10.5811/cpcem.20448.

DOI:10.5811/cpcem.20448
PMID:39704571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11661265/
Abstract

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.

摘要

引言

肾上腺功能不全较少见且更具生命威胁性的病因之一是免疫检查点抑制剂（ICI）诱导的原发性肾上腺功能不全（PAI）。患者通常表现为疲劳、不适和恶心，并接受氢化可的松经验性治疗。

病例报告

我们报告一例59岁女性患者，该患者出现低血压，最初认为是由于血容量不足或药物相关，但最终发现患有PAI。

结论

鉴于ICI诱导的原发性肾上腺功能不全的相关发病率、死亡率及其在有免疫治疗史患者中的发生率，本病例强调了早期检测的重要性。