15 July 2021
: Case report 
Isolated Adrenocorticotropic Hormone Deficiency Associated with Severe Hyperkalemia During Pembrolizumab Therapy in a Patient with Ureteral Cancer and an Ileal Conduit: A Case Report and Literature Review
Unusual clinical course
Yudai Hinata1BCD, Nobumasa Ohara1ABCDEF*, Yuhki Sakurai1CD, Ryo Koda2BCD, Yuichiro Yoneoka3CD, Toshinori Takada4CD, Noboru Hara5BD, Tsutomu Nishiyama5BDDOI: 10.12659/AJCR.931639
Am J Case Rep 2021; 22:e931639
Table 1. Serial changes in levels of morning plasma adrenocorticotropic hormone and cortisol, serum electrolytes, and blood eosinophils, immediately before and during pembrolizumab therapy in 2019. All blood samples were collected in the morning.
| Early July | Late July | Mid-Aug | Late Aug | Mid-Sept | Early Oct | Late Oct | LateNov | |
|---|---|---|---|---|---|---|---|---|
| ACTH (pg/mL) | 43.1 | 45.4 | 22.8 | 42.2 | 62.2 | 68.3 | 71.2 | 16.6 |
| Cortisol (μg/dL) | 12.5 | 11.7 | 7.4 | 12.2 | 12.4 | 10.3 | 11.4 | 1.4 |
| Sodium (mEq/L) | 144 | 141 | 142 | 143 | 144 | 142 | 142 | 134 |
| Potassium (mEq/L) | 5.3 | 5.4 | 5.2 | 5.1 | 4.5 | 4.6 | 4.3 | 6.3 |
| Chloride (mEq/L) | 114 | 114 | 117 | 118 | 118 | 116 | 114 | 113 |
| Creatinine (mg/dL) | 1.58 | 1.94 | 1.77 | 1.78 | 1.90 | 1.95 | 1.83 | 1.79 |
| Eosinophils (/μL) | 139 | 160 | 141 | 159 | 244 | 271 | 316 | 437 |
| White blood cells (/μL) | 3400 | 3800 | 4400 | 3700 | 3700 | 4100 | 4000 | 4200 |
| All blood samples were collected in the morning. | ||||||||