Table 2.
Summary of the clinical course in 5 patients with adrenal insufficiency
| Category | Case 1 | Case 2 | Case 3 | Case 4 | Case 5 |
|---|---|---|---|---|---|
| Chief complaint | Anorexia, malaise | Fever, diarrhea, malaise | Anorexia, malaise | Anorexia, movement difficulty | Malaise |
| Grade (CTCAE v5) | 3 | 3 | 3 | 4 | 2 |
| Time to events, months | 5.60 | 3.00 | 4.63 | 16.13 | 2.13 |
| Hospitalization | + | + | + | + | − |
| PS at onset of AI | 2 | 3 | 2 | 4 | 1 |
| Body weight at diagnosis, kg | 57.3 | 72.2 | 65.1 | 70.0 | 76.5 |
| Body weight at onset of AI, kg | 60.5 | 70.1 | 65.5 | 58.8 | 74.9 |
| Eosinophil count, /µL | 180 | 110 | 501 | 100 | 180 |
| Peripheral blood eosinophil ratios, % | 3.5 | 2.1 | 7.4 | 1.4 | 2.7 |
| ACTH, pg/mL | 2 | 2.3 | <1.0 | 1.1 | 6.6 |
| COR, µg/dL | 0.7 | 1 | <0.2 | 3.8 | 5.6 |
| Corticosteroid replacement | Hydrocortisone | Hydrocortisone | Hydrocortisone | Hydrocortisone | Hydrocortisone |
| Starting dose, mg/day | 20 | 150 | 100 | 200 | 10 |
| Maintenance dose, mg/day | 20 | 20 (day 7-) | 20 (day 9-) | 20 (day 7-) | 10 |
| Discontinuation of pembrolizumab | + | + | − | + | − |
| Resumption of pembrolizumab | + | + | − | ||
| Other irAEs | Skin rash | None | None | Skin rash Hypothyroidism | Hypothyroidism |
| Outcome | Improvement | Improvement | Improvement | Improvement | Improvement |
| PS after improvement of AI | 1 | 1 | 0 | 0 | 1 |
CTCAE, Common Terminology Criteria for Adverse Events; PS, performance status; AI, adrenal insufficiency; ACTH, adrenocorticotropic hormone; COR, Cortisol; irAE, immune-related adverse event.