Table 3.

All-grade adverse events of endocrine system origin in cancer patients treated with ICI [71, 74–81]

System	Organ	Symptoms	Abnormalities in diagnostic test results	Suspected pathology
Endocrine system	Thyroid	Fatigue Weight gain Hair loss Cold intolerance Constipation Depression Bradyphrenia Weakness Decreased exercise tolerance Somnolence General slowness Feeling cold easily Cold, dry skin, Subcutaneous edema ( so called thyroid swelling) Bradycardia Hypotension Water retention Mononeuropathies Reduction in muscle strength Menstrual disorders	High TSH Low fT4 Normal/low T3 Anti-TPO (negative) Hyponatremia Hypercalcaemia USG (usually hypoechogenic)	Primary hypothyroidism
		Weight loss Increased appetite Weakness Heat intolerance Anxiety, irritability Insomnia Thyroid orbitopathy Increased sweating Palpitations Tachycardia Hypertension Diarrhea Hyperhidrosis Exophthalmos Tremors Hypermetabolic activity	Low TSH normal/high T4, T3 Thyroid-stimulating IG anti-TPO, TRAb TSI (thyroid-stimulating immunoglobulin) can be present Radioactive iodine uptake scan/technetium thyroid scan	Primary hyperthyroidism, thyrotoxicosis
	Pituitary gland	Headache Fatigue Nausea/vomiting Orthostatic hypotension Loss of libido Muscle weakness Loss of appetite Loss of weight Cold intolerance Symptoms of optic chiasm compression (visual disturbances) Anorexia	Low/normal TSH Low fT4 Hormone deficiencies (ACTH, TSH, FSH/LH) Normal/low morning cortisol Mild hyponatremia MRI (diffuse pituitary enlargement, funnel enlargement, homogeneous/heterogeneous pituitary enhancement after gadolinium administration	Hypophysitis
	Adrenal glands	Weakness Loss of appetite Muscle pain Fatigue Nausea/vomiting Weight loss Skin hyperpigmentation Abdominal pain Adrenal crisis (weakness, impaired consciousness, vomiting, diarrhea, hypotension, tachycardia, fever)	Hyponatremia Hyperkaliemia Hypoglycemia Hypercalcaemia low morning cortisol level Abnormal cortisol stimulating test Normal/high ACTH Anti-21-hydroxylase and adrenal cortex antibodies	Primary adrenal insufficiency (PAI)
	Beta cells of the pancreas	Polyuria Polydipsia Weight loss Nausea/vomiting Ketoacidosis	Glucose level Oral glucose tolerance test Lack of insulin secretion Undetectable/low C-peptide Test for antibodies (glutamic acid decarboxylase, anti-insulin, anti-islet cell A, C-peptide, zinc transporter 8)	Diabetes type 1 (insulin dependent diabetes mellitus, IDD)