SMF Schweizerisches Medizin-Forum 1424-4020 1424-3784 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 08685 10.4414/smf.2021.08685 Was ist Ihre Diagnose? Allergologie / Immunologie Endokrinologie / Diabetologie und Stoffwechsel Klinische Pharmakologie und Toxikologie Medizinische Onkologie Nephrologie Eine eigenwillige Hypotonie Porret Raphaël raphael.porret@unil.ch Rue du Bugnon 46 | Lausanne | 1011 | SWITZERLAND Rousakis Markos Service de médecine interne, Centre hospitalier universitaire vaudois Obeid Michel Service d’immunologie et allergie, Centre hospitalier universitaire vaudois Waeber Gérard Centre hospitalier universitaire vaudois 28 09 2021 21 3940 672 674 Copyright: EMH Schweizerischer Ärzteverlag AG 2021 EMH Schweizerischer Ärzteverlag AG "Swiss Medical Forum" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing.

L’immunothérapie a changé radicalement la prise en charge oncologique en améliorant d’une manière significative le pronostic de nombreux cancers. Au vu de ces nombreux effets indésirables immuno-induits, y compris endocrinologiques, une insuffisance cortico-surrénalienne doit être évoquée avec un haut degré de suspicion clinique dans le diagnostic différentiel d’une hypotension inexpliquée ou chez un patient en état de choc sans piste alternative évidente. L’importance du dosage du cortisol plasmatique ainsi que de l’ACTH est certaine, orientant la suite de la prise en charge dans la recherche d’une cause étiologique.