Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma

Jo, Soo Yeon; Ryu, Soo Hyung; Kim, Mi Young; Moon, Jeong Seop; Yoon, Won Jae; Kim, Jin Nam

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자료유형: 학술저널

저자정보: Jo, Soo Yeon (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) Ryu, Soo Hyung (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) Kim, Mi Young (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) Moon, Jeong Seop (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) Yoon, Won Jae (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine) Kim, Jin Nam (Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine)

저널정보: 영남대학교 의과대학 영남의대학술지 영남의대학술지 제33권 제2호

발행연도: 2016.1

수록면: 155 - 158 (4page)

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Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <$0.2{\mu}g/dL$ and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.

#Hepatocellular carcinoma #Sorafenib #Adrenal insufficiency #Adverse effects

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