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Hyponatraemia secondary to nivolumab-induced primary adrenal failure.
Trainer, Harris Hulse, Paul Higham, Claire E Trainer, Peter J Lorigan, Paul C
Trainer, Harris
Hulse, Paul
Higham, Claire E
Trainer, Peter J
Lorigan, Paul C
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Abstract
Checkpoint inhibitors, such as ipilimumab and pembrolizumab, have transformed the prognosis for patients with advanced malignant melanoma and squamous non-small-cell lung cancer, and their use will only expand as experience is gained in a variety of other malignancies, for instance, renal and lymphoma. As the use of checkpoint inhibitors increases, so too will the incidence of their unique side effects, termed immune-related adverse events (irAEs), which can affect dermatological, gastrointestinal, hepatic, endocrine and other systems. Nivolumab is a monoclonal antibody that blocks the human programmed death receptor-1 ligand (PD-L1) found on many cancer cells and is licensed for the treatment of advanced malignant melanoma. We describe the first case of nivolumab-induced adrenalitis resulting in primary adrenal failure presenting with hyponatraemia in a 43-year-old man with malignant melanoma. The case highlights the potentially life-threatening complications of checkpoint inhibitors and the need for patient education and awareness of irAEs among the wider clinical community because such side effects require prompt recognition and treatment.
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2016
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Hyponatraemia secondary to nivolumab-induced primary adrenal failure. 2016, Endocrinol Diabetes Metab Case Rep