• Iqra Iqbal, Muhammad Atique Alam Khan, Waqas Ullah, and Dina Nabwani.
• Internal Medicine, Abington Jefferson Health, Abington, Pennsylvania, USA.
• BMJ Case Rep. 2019 Dec 1; 12 (11).

AbstractImmune checkpoint inhibitors (ICIs) are an evolving class of drugs for the treatment of various cancers; for example, their use is recommended as a second-line chemotherapy for non-small cell lung cancer. With the expanding use of ICIs, we are discovering their unique side effects, called immune-related adverse events (irAEs), which can impair gastrointestinal, hepatic, dermatological, endocrine and other systems. Nivolumab is an ICI that blocks the human programmed death receptor-1 (PD-1) on T cells to prevent the interaction between the receptor, PD-1, and human programmed death ligand-1 expressed on tumour cells. Here, we report a case of a 65-year-old woman with recurrent lung adenocarcinoma who was treated with nivolumab and developed immune-related adrenalitis, which was managed with hydrocortisone and fludrocortisone. This case highlights the importance of understanding the irAEs of ICIs to allow prompt recognition and management of life-threatening complications of the treatment.© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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