Nivolumab是免疫检查点抑制剂，用于治疗晚期肾细胞癌（RCC）。已报道肾上腺功能不全与Nivolumab有关的不良事件。我们报告了一例患者在接受Nivolumab治疗1年后发生的肾上腺功能不全。该患者是一名90岁的日本女性。在接受15个疗程的Nivolumab后，出现疲劳和皮质醇水平下降的症状。开始口服羟化可的松30毫克/天后，症状得到改善。Nivolumab没有再次使用，患者仍在门诊观察中。这是RCC治疗后Nivolumab起始1年后出现肾上腺功能不全的首例报道。肾上腺功能不全的症状类似于癌症进展的症状。当接受Nivolumab治疗的患者出现疲劳症状时，应该怀疑肾上腺功能不全，无论Nivolumab使用时间长短。

Nivolumab is an immune checkpoint inhibitor used to treat advanced renal cell carcinoma (RCC). Adrenal insufficiency has been reported as an adverse event associated with nivolumab. We report a case of adrenal insufficiency that occurred more than 1 year after the initiation of nivolumab while patient was still receiving treatment.The patient was a 90-year-old Japanese woman. Fatigue and decreased cortisol levels were observed after 15 courses of nivolumab.The symptoms improved with the initiation of oral hydrocortisone 30 mg once a day. Nivolumab was not resumed, and the patient is still under outpatient observation.This is the first report of RCC with adrenal insufficiency occurring more than 1 year after the initiation of the nivolumab regimen. Symptoms of adrenal insufficiency are similar to those of cancer progression. When symptoms of fatigue occur in patients receiving nivolumab, adrenal insufficiency should be suspected, regardless of the duration from nivolumab initiation.