Isolated adrenocorticotropic hormone deficiency and thyroiditis associated with nivolumab therapy in a patient with advanced lung adenocarcinoma: a case report and review of the literature

Table 3 Endocrinological investigation: CRH/GRF/TRH/LHRH stimulation test in January 2018 (day 7 after admission)

	Time (min)
	0	15	30	60	90	120
Adrenocorticotropic hormone (pg/ml)	2.1	3.5	4.0	3.4	2.9	2.2
Cortisol (μg/dl)	< 0.2	< 0.2	< 0.2	< 0.2	< 0.2	< 0.2
Thyroid-stimulating hormone (μIU/ml)	5.47	22.86	33.95	28.66	23.64	17.65
Growth hormone (ng/ml)	7.67	19.96	34.68	38.76	37.53	21.17
Prolactin (ng/ml)	22.6	75.6	94.4	84.6	61.2	44.6
Luteinizing hormone (mIU/ml)	10.4	21.8	30.9	45.3	47.9	43.1
Follicle-stimulating hormone (mIU/ml)	32.8	36.2	33.6	36.6	45.6	45.5

The following synthetic hypothalamic hormones were intravenously administered in the morning (9 a.m.): human corticotropin-releasing hormone (CRH; 100 μg), growth hormone-releasing factor (GRF; 100 μg), thyrotropin-releasing hormone (TRH; 500 μg), and luteinizing hormone-releasing hormone (LHRH; 100 μg)
The hormone replacement therapy with oral levothyroxine (50 μg/day) for primary hypothyroidism was discontinued on day 2 after admission, and the patient’s serum levels of free thyroxine (1.26 ng/dl) and free triiodothyronine (2.77 pg/ml) were measured just before the drug administration

ISSN: 1752-1947