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Advanced Practice
NCPD Article

Adrenal Insufficiency: Immune Checkpoint Inhibitors and Immune-Related Adverse Event Management

Kiera B. Hobbs
Susan Yackzan
CJON 2020, 24(3), 240-243 DOI: 10.1188/20.CJON.240-243

Adrenal insufficiency (AI) is a potential immune-related adverse event (irAE) of immunotherapy (e.g., checkpoint inhibitor). If not identified and treated promptly, AI can be life-threatening. Unlike other irAEs, AI may be irreversible, requiring long-term glucocorticoid and mineralocorticoid replacement. Provider and patient education are essential in the management of immune checkpoint inhibitor–induced AI.


  • Treatment with immunotherapy may lead to irAEs, such as AI.
  • Glucocorticoid and mineralocorticoid replacement may be required in patients with AI.
  • To manage AI over time, advanced practice RNs must be aware of its signs and symptoms.

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