Fulminant type 1 diabetes mellitus caused by nivolumab
10.3760/cma.j.cn114015-20201202-01203
- VernacularTitle:纳武利尤单抗致暴发性1型糖尿病
- Author:
Suhong WANG
1
;
Yan CHENG
1
;
Maoguang YANG
1
;
Yangfang HE
1
;
Hong SHEN
1
;
Hanqing CAI
1
Author Information
1. 吉林大学第二医院内分泌科，长春 130041
- Publication Type:Journal Article
- Keywords:
Nivolumab;
Antineoplastic agents, immunological;
Diabetes mellitus, type 1
- From:
Adverse Drug Reactions Journal
2021;23(8):436-438
- CountryChina
- Language:Chinese
-
Abstract:
An 82-year-old female patient received monotherapy with nivolumab (240 mg by an IV infusion on the firsr day, 14 days as a cycle) because of multiple metastases of central adenocarcinoma in the right upper lobe of the lung. After 8 cycles of immunotherapy (about 4 months), the patient developed severe nausea and vomiting. Laboratory tests showed random blood glucose 43.2 mmol/L and β-hydroxybutyric acid 5.3 mmol/L. Blood gas analysis showed pH 7.01, bicarbonate root 4.0 mmol/L, alkali residual -22.4 mmol/L, serum potassium 6.1 mmol/L, and lactic acid 2.9 mmol/L. The patient had no previous history of diabetes mellitus. Fulminant type 1 diabetes mellitus due to nivolimab was considered. Nivolumab was stopped and rehydration, hypoglycemia, acidosis correction, and other symptomatic treatments were given. Two days later, her symptoms were improved obviously. Laboratory tests showed fasting plasma glucose 15.8 mmol/L and β-hydroxybutyric acid 0.2 mmol/L. Blood gas analysis showed pH 7.39, bicarbonate root 21.2 mmol/L, alkali residual -3.8 mmol/L, serum potassium 4.3 mmol/L, and lactic acid 1.0 mmol/L.
