Hi, I’m sorry you and your husband are dealing with melanoma. I wish this club would close because of no more melanoma patients.
Regarding the adrenal crisis after Ipi/Nivo, most likely your husband experienced Hypophysitis from Ipi. After the third infusion is exactly when I experienced it. Hypophysitis is swelling of the pituitary gland. When it swells then it stops producing some of the 8 hormones it normally produces. The prednisone will reduce the swelling and stop the immune system from attacking the pituitary. However, most of the function of the pituitary usually does not return (each patient is unique in this regard).
Looking up Hypophysitis online doesn’t produce a lot of information because there are a limited number of people who have experienced in from immunotherapy. But looking up adrenal insufficiency produces a lot of info.
Your health system will refer your husband to an endocrinologist who will continue treatment (hydrocortisone, thyroxine, and possibly testosterone). It is through the endocrinologist that your husband will get back to feeling normal (having the right balance of replacement hormones). Then things will seem fine again.
Most likely your husband will be able to continue with Nivo (or switch to Pembro) but not Ipi.
Note: If you look up the lab results from the second and third infusion you will see the TSH and Free T4 both drop.
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