Fulminant type 1 diabetes mellitus caused by pembrolizumab
10.3760/cma.j.cn114015-20220126-00082
- VernacularTitle:帕博利珠单抗致暴发性1型糖尿病
- Author:
Minqiong TANG
1
;
Pengli ZHU
Author Information
1. 桂林市人民医院药学部，桂林 541500
- Publication Type:Journal Article
- Keywords:
Diabetic ketoacidosis;
Immune checkpoint inhibitors;
Pembrolizumab
- From:
Adverse Drug Reactions Journal
2022;24(9):500-502
- CountryChina
- Language:Chinese
-
Abstract:
A 73-year-old female patient received monotherapy with pembrolizumab (IV infusion of 200 mg once every 3 weeks) for lung cancer with bone metastases. On day 12 after the 6th treatment with pembrolizumab, the patient developed severe nausea and vomiting. Laboratory tests showed random blood glucose 53.6 mmol/L and serum potassium 6.8 mmol/L. Blood gas analysis showed pH 7.3, partial pressure of carbon dioxide 19.5 mmHg, partial pressure of oxygen 15.6 mmHg, base excess -8.9 mmol/L, bicarbonate 9.5 mmol/L, lactic acid 2.5 mmol/L, and anionic gap 23.5 mmol/L. Blood ketone body test was positive. The patient had no previous history of diabetes mellitus, fulminant type 1 diabetes mellitus and ketoacidosis due to pembrolizumab were considered. Pembrolizumab were stopped and rehydration, hypoglycemia, acidosis correction, and other symptomatic treatments were given. Seven days later, her symptoms were improved partly. Laboratory tests showed fasting blood glucose 12.9 mmol/L and serum potassium 4.5 mmol/L. Blood gas analysis showed pH 7.5, bicarbonate 28.3 mmol/L, and base excess +5.7 mmol/L. Blood ketone body test was negative.
