Autoimmune diabetes mellitus induced by sintilimab
10.3760/cma.j.cn114015-20210315-00305
- VernacularTitle:信迪利单抗致自身免疫性糖尿病
- Author:
Lixiang FU
1
;
Ping XIAO
;
Jie SUN
;
Guyu LI
;
Yuanyuan WEI
Author Information
1. 广西壮族自治区柳州市妇幼保健院药学部，柳州 545001
- Publication Type:Journal Article
- Keywords:
Immune checkpoint inhibitors;
Adenocarcinoma;
Sintilimab
- From:
Adverse Drug Reactions Journal
2022;24(2):101-103
- CountryChina
- Language:Chinese
-
Abstract:
A 69-year-old female patient received immunotherapy with intravenous infusion of sintilimab 200 mg once per 21 days because of recurrence of left lung adenocarcinoma after operation. The patient had no history of diabetes mellitus and blood sugar level was normal before treatment. Three days after the first intravenous infusion of sintilimab, the patient felt dry mouth and fatigue, 10 days later her symptoms were worsened, accompanied by nausea. Laboratory examination showed random blood glucose 27.0 mmol/L and hypoglycemic treatment was given. On the 29th day of intravenous infusion of sintilimab, oral glucose tolerance test showed that fasting, 1, 2 and 3 hours postprandial blood glucose levels were higher than those of the upper reference value, C-peptide and insulin were lower than those of the lower reference value, urine routine showed ketone bodies (±) and glucose (++++). Autoimmune diabetes mellitus caused by sintilimab was considered. After several adjustments, the hypoglycemic regimen was finally determined as recombinant human insulin injection 12 units subcutaneously before morning and evening meals, 14 units before lunch; albumin biosynthesis human insulin injection 12 units subcutaneously at bedtime. Five days later, the patient′s symptoms such as dry mouth, fatigue, and nausea disappeared, with fasting glucose 4.8-5.8 mmol/L and postprandial glucose 7.8-8.7 mmol/L. Urine routine examination showed negative ketone body and glucose.
