Nivolumab, a new immunomodulatory drug, a new adverse effect; adrenal crisis

Turkish Journal of Emergency Medicine
Funda Karbek AkarcaYusuf Ali Altunci

Abstract

Owing to the advancements in medicine, new information is obtained regarding cancer, new antineoplastic agents are developed. Frequent use of these new pharmacological agents emergency physicians to be vigilant about their side effects. We present a case of adrenal crisis in a patient with non-small cell lung cancer (NSCLC), caused by an immunomodulatory drug; nivolumab. While adverse events are related to other immunomodulatory drugs have been reported in literature, our case is the first nivolumab-related adrenal failure to be reported. A patient with lung cancer presented to the emergency room(ER) with nausea and vomiting. Hyponatremia, hyperkalemia, persistent hypoglycemia led to the diagnosis of adrenal crisis. Having direct effect on the immune system, these drugs were claimed to be highly reliable. However, there is no reliable data on the side effect profile of these agents. It should be kept in mind that life-threatening auto-immune reactions may occur.

References

Mar 23, 2012·Nature Reviews. Cancer·Drew M Pardoll
Aug 3, 2013·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Caroline RobertAlexander M M Eggermont
Mar 11, 2015·Therapeutic Advances in Medical Oncology·Raghav SundarRoss A Soo
Apr 22, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Scott N GettingerJulie R Brahmer
Jan 21, 2016·Cancer Immunology Research·Antoni RibasBegoña Comin-Anduix

❮ Previous
Next ❯

Citations

Apr 30, 2020·Immunotherapy·Maria V DeligiorgiDimitrios T Trafalis
Aug 29, 2019·The New England Journal of Medicine·R Louise RushworthHenrik Falhammar
Jan 7, 2020·Therapeutic Advances in Endocrinology and Metabolism·Edson NogueiraDaniel L Morganstein
Sep 5, 2020·Annual Review of Medicine·Zoe QuandtMark S Anderson
Sep 4, 2020·Seminars in Respiratory and Critical Care Medicine·Gennaro MartucciKarin Amrein
Feb 9, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Yun ShiTao Yang

❮ Previous
Next ❯

Methods Mentioned

BETA
urine stick

Related Concepts

Related Feeds

Addison Disease

Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.