Normal adrenocorticotropic hormone levels do not exclude adrenal insufficiency during immune checkpoint inhibitor therapy: evidence from clinical, steroid, and structural analyses
Adrenal insufficiency may occur when plasma ACTH levels remain within or above the normal range. Diagnosis based solely on ACTH measurements risks underrecognition of ICI-IAD. Comprehensive endocrine assessment-including dynamic hormone testing and detailed steroid profiling-enhances diagnostic accuracy and informs timely intervention.
Authors
- Ryuta Baba (ORCID: https://orcid.org/0000-0002-7596-4715)
- Gaku Nagano (ORCID: https://orcid.org/0000-0003-0291-4669)
- Y. Ishibashi (ORCID: https://orcid.org/0000-0002-7685-0015)
- Noboru Hattori (ORCID: https://orcid.org/0000-0002-8234-942X)
- Akira Okada (ORCID: https://orcid.org/0000-0001-6480-3388)
- Masataka Tsuge (ORCID: https://orcid.org/0000-0001-7591-8287)
- Yu Otagaki
- Tsuguka Matsuda (ORCID: https://orcid.org/0000-0003-3023-808X)
- Gentaro Egusa
- Atsushi Ono (ORCID: https://orcid.org/0000-0002-2482-945X)
- Haruya Ohno (ORCID: https://orcid.org/0000-0001-5400-1162)
- Ryoichi Miura
- Takaya Kodama
Institutions
- Hiroshima University (JP)
- Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital (JP)
- Hiroshima University Hospital (JP)
Publication Details
- Journal
- Frontiers in Endocrinology
- Published
- 2025-10-20
- DOI
- https://doi.org/10.3389/fendo.2025.1683546
- Primary Topic
- Adrenal Hormones and Disorders
- Type
- article
- Field-Weighted Citation Impact
- 0.00