Adrenal Insufficiency: Immune Checkpoint Inhibitors and Immune-Related Adverse Event Management

Clin J Oncol Nurs. 2020 Jun 1;24(3):240-243. doi: 10.1188/20.CJON.240-243.

Abstract

Adrenal insufficiency (AI) is a potential immune-related adverse event (irAE) of immunotherapy (e.g., checkpoint inhibitor). If not identified and treated promptly, AI can be life-threatening. Unlike other irAEs, AI may be irreversible, requiring long-term glucocorticoid and mineralocorticoid replacement. Provider and patient education are essential in the management of immune checkpoint inhibitor-induced AI.

Keywords: adrenal insufficiency; immune checkpoint inhibitor; immune-related adverse event.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Insufficiency / chemically induced*
  • Adrenal Insufficiency / drug therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Curriculum
  • Education, Nursing, Continuing
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunotherapy / adverse effects
  • Male
  • Middle Aged
  • Mineralocorticoids / therapeutic use*
  • Neoplasms / drug therapy*
  • Nivolumab / adverse effects*
  • Nivolumab / pharmacology
  • Nursing Staff, Hospital / education
  • Oncology Nursing / education

Substances

  • Glucocorticoids
  • Immune Checkpoint Inhibitors
  • Mineralocorticoids
  • Nivolumab