What question did this study set out to answer?

To illustrate the link between pembrolizumab and adrenal crisis in a cervical cancer patient.

May 7, 2026Open Access

Pembrolizumab-Induced Adrenal Crisis Indicated by Increased 18F-Fluoro-D-Deoxyglucose Uptake in Bilateral Adrenal Glands Prior to Onset

Key Points

To illustrate the link between pembrolizumab and adrenal crisis in a cervical cancer patient.
Case report of a 51-year-old female with cervical cancer.
Assessment of symptoms and imaging via PET/CT prior to admission.
Evaluation of immune-related adverse events related to pembrolizumab.
The patient experienced adrenal crisis following pembrolizumab administration.
PET/CT indicated increased uptake in bilateral adrenal glands.
Nonspecific symptoms of adrenal insufficiency were noted prior to crisis.

Abstract

We present a case of adrenal crisis induced by pembrolizumab in a 51-year-old female patient diagnosed with cervical cancer (cT2bN1M1, cStageIVB). Immune checkpoint inhibitors are known to trigger serious immune-related adverse events (irAEs), such as primary adrenal insufficiency. The patient exhibited nonspecific symptoms such as loss of appetite, fever, and shock, indicating pituitary and adrenal insufficiency attributed to pembrolizumab. 18F-fluoro-D-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), performed four days prior to admission, had revealed increased diffuse FDG uptake in bilateral adrenal glands, suggesting potential adrenal crisis. This case underscores that those PET/CT findings may represent an initial indicator of following adrenal irAEs, facilitating early diagnosis and intervention.

Pembrolizumab-Induced Adrenal Crisis Indicated by Increased 18F-Fluoro-D-Deoxyglucose Uptake in Bilateral Adrenal Glands Prior to Onset

Key Points

Abstract

Cite This Study