Evidence map›Paper›PMID 37405219›Full record

ArticleCancer diagnosis & prognosis

Hypothyroidism With ACTH Deficiency During Pembrolizumab Therapy for Lung Cancer: Case Report and Literature Review.

Asato Hashinokuchi, Akira Haro, Reiko Minagawa, Yasuhiro Haruta, Hiroyuki Kawano, Taketoshi Suehiro, Keizo Sugimachi

Open access · bronzeAbstract read
In one paragraph

Article in Cancer diagnosis & prognosis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Asato HashinokuchiDepartment of Thoracic Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Akira HaroDepartment of Thoracic Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Reiko MinagawaDepartment of Diabetes and Internal Medicine, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Yasuhiro HarutaDepartment of Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Hiroyuki KawanoDepartment of Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Taketoshi SuehiroDepartment of Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Keizo SugimachiDepartment of Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan.
Shiga Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimImmune-checkpoint inhibitors have recently shown great promise in treating various cancers, but often cause immune-related adverse events (irAEs). Simultaneous drug-induced hypothyroidism and isolated adrenocorticotropic hormone (ACTH) deficiency are rare irAEs. This combination of irAEs is associated with paradoxical endocrine dysfunction characterized by large amounts of thyroid-stimulating hormone (TSH) and small amounts of ACTH in the anterior lobe of the pituitary. We herein report a case of hypothyroidism with isolated ACTH deficiency during pembrolizumab therapy for recurrent lung cancer. CASE REPORT: Our patient was a 66-year-old man with recurrence of squamous cell lung carcinoma. Four months after chemotherapy that included pembrolizumab, the patient presented with general fatigue and laboratory tests showed high concentrations of TSH with low concentrations of free-T4. He was diagnosed with hypothyroidism and levothyroxine was prescribed. His ACTH concentration was found to be low 1 week later when he developed an acute adrenal crisis with associated hyponatraemia. We then changed his diagnosis to concurrent hypothyroidism with isolated ACTH deficiency. His condition improved after 3 weeks of administration of cortisol.

conclusionIt is difficult to diagnose a concurrent paradoxical endocrine disorder, such as hypothyroidism with isolated ACTH deficiency, as in the present case. Physicians should pay attention to symptoms and laboratory data to identify various types of endocrine disorders as irAEs.

Indexed as

Hypopituitarismhypothyroidismimmune-checkpoint inhibitorsimmune-related adverse eventsisolated ACTH deficiencylung cancer

Identifiers

PMID37405219
PMCPMC10316054
OpenAlexW4382939067

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.