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15 July 2021: Articles

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 Hinata B , Nobumasa Ohara A* , Yuhki Sakurai C , Ryo Koda B , Yuichiro Yoneoka C , Toshinori Takada C , Noboru Hara B , Tsutomu Nishiyama B

DOI: 10.12659/AJCR.931639

Am J Case Rep 2021; 22:e931639

Table 3. Laboratory findings on admission in November 2019.

  Total protein7.2 g/dL(6.6–8.1)
  Albumin3.4 g/dL(4.1–5.1)
  Creatine phosphokinase83 U/L(41–153)
  Urea nitrogen37.4 mg/dL(8.0–20.0)
  Creatinine1.79 mg/dL(0.46–0.79)
  Sodium134 mEq/L(135–147)
  Potassium6.3 mEq/L(3.5–4.8)
  Chloride113 mEq/L(98–108)
  C-reactive protein0.85 mg/dL(0–0.14)
  Casual plasma glucose119 mg/dL(70–139)
  Adrenocorticotropic hormone16.6 pg/mL(7.2–63.3)
  Cortisol1.4 μg/dL(7.1–19.6)
  Plasma renin activity15.7 ng/mL/h(0.2–2.3)
  Aldosterone12.3 ng/dL(3.0–15.9)
  Arginine vasopressin0.9 pg/mL
  Thyroid-stimulating hormone4.80 μIU/mL(0.50–5.00)
  Free thyroxine1.46 ng/dL(0.90–1.70)
  Free triiodothyronine2.57 pg/mL(2.30–4.00)
  Bicarbonate ion13.0 mmol/L
  Partial carbon dioxide pressure34.2 mmHg
  Partial oxygen pressure37.5 mmHg
  Base excess−13.6 mmol/L
  Lactic acid9.0 mg/dL
  Anion gap9.8 mmol/L
The reference range for each parameter is shown in parentheses. Blood samples were collected in the morning with the patient in the supine position.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923