Fulminant type 1 diabetes mellitus caused by tirelizumab
10.3760/cma.j.cn114015-20220328-00249
- VernacularTitle:替雷利珠单抗致暴发性1型糖尿病
- Author:
Min RUI
1
;
Zhonghua ZHU
1
Author Information
1. 安徽省黄山市人民医院药剂科，黄山 245000
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus, type 1;
Diabetic ketoacidosis;
Tilizumabyu;
Immune-related adverse events
- From:
Adverse Drug Reactions Journal
2023;25(1):53-55
- CountryChina
- Language:Chinese
-
Abstract:
A 73-year-old male patient with metastatic sarcomatoid carcinoma of lymph node received an IV infusion of tirelizumab 200 mg on day 1, and 3 weeks was 1 cycle. After 10 cycles of treatment, the patient developed dizziness, chest tightness, nausea, and vomiting. Laboratory tasts showed random blood glucose 99.1 mmol/L, serum creatinine (Scr) 260 μ mo/L, blood potassium 5.8 mmo/L, blood sodium 129 mmol/L, and blood osmotic pressure 368 mOsm/(kg·H 2O). Blood gas analysis showed pH 7.1 and lactic acid 2.8 mmol/L. Ketoacidosis was considered and treatments such as rehydration, hypoglycemic with insulin, and electrolyte supplement were given. After 5 days of treatments, the patient′s symptoms were improved, and laboratory tests showed blood potassium 4.4 mmol/L, blood sodium 134 mmol/L, carbon dioxide binding capacity 17.0 mmol/L, and fasting C-peptide 0.02 nmol/L. Seven days later, laboratory tests showed fasting C-peptide 0 and 2 h post-prandial C-peptide 0. The patient was diagnosed with fulminant type 1 diabetes mellitus, which was considered to be related to tirelizumab. After 19 days of treatments, laboratory tests showed fasting blood glucose 5.8 mmol/L, blood glucose at 2 hours after meal 19 mmol/L, Scr 102 μmol/L, blood sodium 139 mmol/L, blood chlorine 108 mmol/L, and blood potassium 3.9 mmol/L.
