One case of type 1 diabetes caused by PD-1 inhibitor and literature review
10.3760/cma.j.issn.1000-6699.2019.07.004
- VernacularTitle:一例PD-1抑制剂导致1型糖尿病病例报道及文献复习
- Author:
Hailuan ZENG
1
;
Xiaomu LI
;
Xin GAO
Author Information
1. 复旦大学附属中山医院内分泌科
- Keywords:
PD-1 inhibitor;
Diabetes mellitus,type 1
- From:
Chinese Journal of Endocrinology and Metabolism
2019;35(7):559-563
- CountryChina
- Language:Chinese
-
Abstract:
This article reported a case of type 1 diabetes caused by a programmed death-1 ( PD-1) inhibitor. The patient was a 52-year-old man with metastatic renal cell carcinoma who received the combined therapy of PD-1 inhibitor Nivolumab and vascular endothelial growth factor ( VEGF) inhibitor Bevacizumab. He presented with thirst, polydipsia, polyuria, repeated vomiting, and fatigue 9 weeks after initiation of the therapy and developed into diabetic ketoacidosis (DKA) about 2 weeks later, with blood glucose 50.9 mmol/L, HbA1C8.4％, serum fasted and glucose-loaded C peptide<0.01 ng/ml, arginine test negative, and autoantibodies negative. The patient was diagnosed as type 1 diabetes caused by the PD-1 inhibitor and was given intensive glucose lowering treatment with insulin, water and electrolyte disorders were also corrected. His symptoms improved but he had to continue insulin treatment. It is recommended to check baseline glucose level prior to the initiation of treatment with PD-1 inhibitor, and should carefully monitor the clinical symptoms and glucose levels during the treatment. Timely detection, correct diagnosis and treatment are important to ensure patients' safety and to improve their prognosis.
