Table 3 Case timeline
Date | Events |
|---|---|
July 20XX-5 | • The patient was diagnosed with stage IIIB lung adenocarcinoma. |
July–November 20XX-5 | • After chemoradiotherapy, the patient’s lung cancer achieved a complete response. |
August 20XX-2 | • A recurrence of NSCLC was diagnosed. |
September 20XX-2 | • Pembrolizumab was started. |
June 20XX-1 | • After the 11th cycle of pembrolizumab, CT revealed increased liver metastasis, and pembrolizumab was discontinued. CBDCA and nab-PTX chemotherapy were started. |
August 20XX-1 | • During the third cycle of chemotherapy, the patient began to experience fatigue and dyspnoea. Anorexia was not persistent. |
November 20XX-1 | • At the beginning of the fifth cycle, the patient reported shortness of breath upon exertion. Fatigue and anorexia became persistent. |
December 20XX-1 | • On day 23 of the fifth cycle, fever and diarrhoea appeared. |
January 20XX | • Fatigue and anorexia persisted without chemotherapy, and the ECOG-PS was 2. It was decided that chemotherapy should be discontinued. |
February 20XX | • Cortisol and ACTH levels were markedly decreased, and secondary AI was suspected. Hydrocortisone sodium succinate was intravenously administered, and hydrocortisone was administered orally. |
March 20XX: Day 1 of admission | • Cortisol and ACTH levels at 15:00 and 23:00 were low. |
Day 2 | • Cortisol and ACTH levels at 7:00 and 10:00 were low. The patient’s pituitary was scanned using contrast-enhanced MRI, and basic hormone levels were measured. |
Day 3 | • Cortisol level was hyporesponsive in a rapid ACTH loading test. |
Day 4 | • Cortisol, ACTH, and TSH levels were hyporesponsive in the CRH, TRH, and GnRH loading tests. |
Day 5 | • The GHRP-2 loading test showed a normal response for GH. Based on previous endocrine function tests, the patient was diagnosed with secondary AI due to ACTH deficiency. |