2017
DOI: 10.1111/jdi.12679
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Aggravation of diabetes, and incompletely deficient insulin secretion in a case with type 1 diabetes‐resistant human leukocyte antigen DRB1*15:02 treated with nivolumab

Abstract: Anti‐programmed cell death‐1 (PD‐1) antibody therapy induces various adverse effects, especially in the endocrine system. Several cases of acute‐onset insulin‐dependent diabetes after anti‐PD‐1 antibody therapy have been reported. Many of these cases have a susceptible human leukocyte antigen (HLA) genotype for type 1 diabetes, possibly suggesting that HLA might be involved in the onset of diabetes with anti‐PD‐1 therapy. We describe an atypical case of hyperglycemia after anti‐PD‐1 antibody administration. A … Show more

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Cited by 26 publications
(25 citation statements)
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References 9 publications
(13 reference statements)
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“…Table 3 summarizes previously published case reports on PD-1 inhibitor-related T1DM, including DKA and changes in the serum level of CPR (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Most previously reported patients had depleted insulin secretion or DKA at their initial visit; 2 patients reported by Matsumura et al and Saito et al had preserved CPR levels without DKA (20,21). As with our patient, their subject's insulin secretion was gradually depleted.…”
Section: Discussionsupporting
confidence: 71%
See 1 more Smart Citation
“…Table 3 summarizes previously published case reports on PD-1 inhibitor-related T1DM, including DKA and changes in the serum level of CPR (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Most previously reported patients had depleted insulin secretion or DKA at their initial visit; 2 patients reported by Matsumura et al and Saito et al had preserved CPR levels without DKA (20,21). As with our patient, their subject's insulin secretion was gradually depleted.…”
Section: Discussionsupporting
confidence: 71%
“…Given the patient's CPR level of 5.92 ng/mL, his ability to secrete insulin appeared to be preserved at the time of his first visit, which might have caused us to overlook the onset of FT1DM. Table 3 summarizes previously published case reports on PD-1 inhibitor-related T1DM, including DKA and changes in the serum level of CPR (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Most previously reported patients had depleted insulin secretion or DKA at their initial visit; 2 patients reported by Matsumura et al and Saito et al had preserved CPR levels without DKA (20,21).…”
Section: Discussionmentioning
confidence: 94%
“…Matsumura et al . also described a person with pre‐existing diet‐controlled diabetes, who developed severe hyperglycaemia with very low C‐peptide level and persistently negative GAD antibody on nivolumab. Person 9 had been on a stable dose of a sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor for over 6 months and was well on the day of anti‐PD1 treatment.…”
Section: Discussionmentioning
confidence: 99%
“…The incidence of immunotherapy‐induced Type 1 diabetes is reported to be ~0.4% ; however, reports suggest that the real‐world incidence may be significantly higher . Cohort studies of islet antibody‐positive people (mainly first‐degree relatives of people with Type 1 diabetes) have found that ~10% with a single positive antibody will progress to Type 1 diabetes .…”
Section: Introductionmentioning
confidence: 99%
“…While hypophysitis and thyroid disorders are predominant, checkpoint-blockade associated diabetes mellitus deserves further notice. Its presentation is often severe with fulminant diabetes and ketoacidosis [142]. Its onset ranges from a few weeks [143] up to one year after initiating therapy [144].…”
Section: Diabetes Mellitusmentioning
confidence: 99%