scholarly journals Rapid onset type-1 diabetes and diabetic ketoacidosis secondary to nivolumab immunotherapy: a review of existing literature

2019 ◽  
Vol 12 (8) ◽  
pp. e229568 ◽  
Author(s):  
Hafez Mohammad Ammar Abdullah ◽  
Radowan Elnair ◽  
Uzma Ikhtiar Khan ◽  
Muhammad Omar ◽  
Oscar L Morey-Vargas

Nivolumab is a programmed cell death receptor (PD-1) inhibitor that is increasingly used for various malignancies, both as a first line agent and as salvage therapy. Being a PD-1/PD-1 ligand checkpoint inhibitor, it is known to cause autoimmune inflammation of various organs and has been associated with thyroiditis, insulitis, colitis, hepatitis and encephalitis to name a few. There are increasing reports of nivolumab leading to acute onset fulminant type 1 diabetes and diabetic ketoacidosis (DKA). We present a case of a 68-year-old man who developed DKA after 2 doses of nivolumab for metastatic melanoma. He was found to have type 1 diabetes, but no diabetes related antibodies were positive. He recovered from diabetes and continues to use insulin 1 year after his diagnosis. This case and associated review illustrates the importance of educating and monitoring patients who start nivolumab therapy regarding this potentially life threatening complication.

2016 ◽  
Vol 53 (5) ◽  
pp. 853-856 ◽  
Author(s):  
Sung Hye Kong ◽  
Seo Young Lee ◽  
Ye Seul Yang ◽  
Tae Min Kim ◽  
Soo Heon Kwak

2018 ◽  
Vol 9 (5) ◽  
pp. 1091-1099 ◽  
Author(s):  
Hiroto Sasamori ◽  
Tomoyasu Fukui ◽  
Toshiyuki Hayashi ◽  
Takeshi Yamamoto ◽  
Makoto Ohara ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Zhen Wang ◽  
Ying Zheng ◽  
Yiting Tu ◽  
Zhijie Dai ◽  
Jian Lin ◽  
...  

Background.Fulminant type 1 diabetes (FT1D) is a novel subtype of type 1 diabetes characterized by extremely rapid onset and complete deficiency of insulin due to the destruction of pancreaticβcells. However, the precise mechanisms underlying the etiology of this disease remain unclear.Methods.A total of 22 patients with FT1D and 10 healthy subjects were recruited. Serum antibodies to GAD, IA2, and ZnT8 in patients were tested. And peripheral T cell responses to GAD65, insulin B9–23 peptide, or C peptide were determined in 10 FT1D patients and 10 healthy controls. The mRNA levels of several related cytokines and molecules, such as IFN-γ, IL-4, RORC, and IL-17 in PBMCs from FT1D patients were analyzed by qRT-PCR.Result.We found that a certain proportion of Chinese FT1D patients actually have developed islet-related autoantibodies after onset of the disease. The GAD, insulin, or C peptide-reactive T cells were found in some FT1D patients. We also detected a significant increase for IFN-γexpression in FT1D PBMCs as compared with that of healthy controls.Conclusion.Autoimmune responses might be involved in the pathogenesis of Chinese FT1D.


2018 ◽  
Vol 93 (2) ◽  
pp. 216-219
Author(s):  
Dug-Hyun Choi ◽  
Bo-Yeon Kim ◽  
Chan-Hee Jung ◽  
Chul-Hee Kim ◽  
Sung-Koo Kang ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document