Two additional cases of severe, recurrent hyponatremia after PD-1 therapy were also reviewed.<h4>Interventions</h4>The patient received targeted hormone replacement therapy, including glucocorticoids and levothyroxine, along with insulin for glycemic control.<h4>Outcomes</h4>Symptoms improved significantly, and biochemical parameters normalized following treatment, demonstrating effective management of multi-glandular endocrine failure induced by PD-1 blockade.<h4>Lessons</h4>PD-1 inhibitors can cause severe, concurrent dysfunction of multiple endocrine organs. This evidence concerns the gene PDCD1 and Hyponatremia.