Table 4.

Cases that have 3 irAEs including secondary adrenal insufficiency due to ICI therapy.

Case	Age	Sex	Primary disease	Therapy	Endocrine irAEs*	Signs of secondary adrenal insufficiency	D to hypophysitis diagnosis from first administration
Sum M (2018)[21]	75	M	Melanoma	Nivo + Ipi	T1D → AD = hypothyroidism	Hypoglycemia, malaise	NA
Khalid M (2019)[22]	53	M	Malignant melanoma	Nivo + Ipi	primary hypothyroidism → IAD → T1D	Refractory hypotension	6 mo
Lanzolla G (2019)[23]	60	M	Lung adeno-carcinoma	Atezo	T1D → Addison disease = hypophysitis	Hyperkalemia and hyponatremia	12 wk
Takata M (2022)[24]	59	M	Malignant melanoma	Nivo	Thyroiditis → IAD → acute T1D	Nausea	14 wk
Hino C (2022)[25]	45	M	Sarcomatoid renal cell carcinoma	Nivo + Ipi	Thyroiditis → T1D → AD	Fatigue and memory loss	244 d
Ishiguro A (2022)[26]	67	M	Malignant melanoma	Nivo	T1D = thyroiditis → IAD	Malaise and loss of appetite	57 d
Luo J (2022)[27]	76	M	Non-small cell lung cancer	Pem	Hypothyroidism → T1D → AD	Hyponatremia	14 mo
This case	81	M	Renal cell carcinoma	Nivo + Ipi	Thyroiditis → fulminant T1D → IAD	Hypotension and fatigue	89 d

Atezo = Atezolizumab, ICI = immune checkpoint inhibitor, Ipi = ipilimumab, Nivo = nivolumab, Pem = Pembrolizumab, T1D = type 1 diabetes.

^*Endocrine irAEs are listed in order of onset.