Abstract
Background. Immune checkpoint inhibitors are used more frequently now for the treatment of non-small cell lung cancer than ever before. Various immune-related adverse events have been reported, and the management of these events is regarded to be important. Case. A 70-year-old man was administered nivolumab for the treatment of advanced non-small cell lung cancer. However, we did not re-administer nivolumab because severe diarrhea and vomiting occurred a few days after this administration. He began to complain of general fatigue and a poor appetite, and he also suffered from hyponatremia 10 months after the administration. Despite treatment for his hyponatremia, the symptoms did not improve. The patient reported a cold sensation, and hypotension occurred. A close examination helped us to diagnose pituitary dysfunction and secondary adrenal insufficiency. After the oral administration of hydrocortisone, these symptoms disappeared quickly. Conclusion. We always need to be alert for the immune-related adverse effects of immune checkpoint inhibitors, even after a single administration.
