Endocrine system
Brian J Pollard, Gareth Kitchen in Handbook of Clinical Anaesthesia, 2017
Primary adrenocortical insufficiency is the inability of the adrenal cortex to secrete cortisol and aldosterone due to destruction of the gland. Classical Addison’s disease is caused by an autoimmune process and is important because it is frequently part of the autoimmune polyendocrine syndrome, type 2 (APS-II) that includes Hashimoto thyroiditis hypothyroidism and type I diabetes mellitus. Patients should therefore undergo appropriate endocrine screening. Other causes of primary adrenocortical insufficiency are given in Table 6.2.
Immune checkpoint inhibitors-induced diabetes mellitus: a growing clinical presentation requiring our attention
Published in Expert Opinion on Drug Safety, 2022
Djordje S. Popovic, Theocharis Koufakis, Bojan Kovacevic, Manfredi Rizzo, Nikolaos Papanas
Nonetheless, given that ICs are vital for the preservation of immunological self-tolerance, their inhibition may trigger adverse events of autoimmune origin [4]. Indeed, endocrine complications (hypophysitis, thyroid dysfunction, diabetes mellitus (DM), primary adrenal insufficiency, and autoimmune polyendocrine syndrome type 2) are among the most common adverse effects of ICIs therapy [4], and their development may also be a predictor of response to ICIs therapy [5,6]. New-onset DM is one of the potential immune-related adverse events associated with ICIs administration. It usually resembles type 1 DM (T1DM) in its pathophysiology and clinical presentation, although some individuals may present with features of type 2 DM or with worsening hyperglycemia in case of preexistent abnormal glucose tolerance or previously diagnosed DM [7].
Related Knowledge Centers
- Autoimmune Polyendocrine Syndrome
- ADDison'S Disease
- Thyroid Disease
- Type 1 Diabetes
- Gene
- Leukocyte Antigen
- Hla-Dq2
- Hla-Dr4
- Nausea
- Urination