Immune-related Adverse Event with Checkpoint Inhibitors Might Be an Emerging Underlying Disease of Steroid-related Osteonecrosis of the Femoral Head: A Case Report

INTRODUCTION: Immune checkpoint inhibitors (ICIs) are increasingly being used in the treatment of advanced metastatic and immunogenic cancers. However, these therapies could cause immune-related adverse events (irAEs), which require high-dose glucocorticoid administration. CASE REPORT: A 52-year-old man with metastatic renal cell carcinoma received ICI therapy. Two weeks later, he suffered from severe irAEs and received glucocorticoid therapy for 13 months. Twenty-one months after the initiation of glucocorticoid administration, he presented to us with bilateral hip pain and was diagnosed with bilateral osteonecrosis of the femoral head (ONFH). CONCLUSION: IrAEs associated with ICI therapy might be an emerging underlying disease of ONFH.