Pembrolizumab-Induced Diabetic Ketoacidosis: A Review of Critical Care Case.

Diabetic ketoacidosis (DKA) is a commonly encountered diagnosis in the general inpatient and intensive care unit settings. We report a rare case of pembrolizumab-induced DKA in a patient with bladder carcinoma in situ with no prior diagnosis of diabetes. Our case highlights the importance of understanding immune-related adverse events (IRAEs) as immunotherapy is becoming a mainstay of treatment for a variety of diagnoses. The rare side effect of DKA presented in this case is compared to the classical presentation of DKA secondary to type 1 diabetes mellitus (T1DM). We found that pembrolizumab-induced DKA presented with fewer symptoms than T1DM-induced DKA and did not present with serum antibodies that are typically present in T1DM. While management of DKA in the acute setting is unchanged regardless of the precipitating factor, this case demonstrates the importance of identifying the precipitant in order to pursue the appropriate diagnostic workup and long-term management.

Oncogenic Role of THOR, a Conserved Cancer/Testis Long Non-coding RNA.

Large-scale transcriptome sequencing efforts have vastly expanded the catalog of long non-coding RNAs (lncRNAs) with varying evolutionary conservation, lineage expression, and cancer specificity. Here, we functionally characterize a novel ultraconserved lncRNA, THOR (ENSG00000226856), which exhibits expression exclusively in testis and a broad range of human cancers. THOR knockdown and overexpression in multiple cell lines and animal models alters cell or tumor growth supporting an oncogenic role. We discovered a conserved interaction of THOR with IGF2BP1 and show that THOR contributes to the mRNA stabilization activities of IGF2BP1. Notably, transgenic THOR knockout produced fertilization defects in zebrafish and also conferred a resistance to melanoma onset. Likewise, ectopic expression of human THOR in zebrafish accelerated the onset of melanoma. THOR represents a novel class of functionally important cancer/testis lncRNAs whose structure and function have undergone positive evolutionary selection.

Suprasellar Germinoma Presenting with Slipped Capital Femoral Epiphysis: Case Report.

Slipped capital femoral epiphysis (SCFE) is a fracture that results from displacement of the proximal femoral epiphysis from the femoral neck. SCFE can be caused by various endocrinopathies that lead to bone weakening in both adult and pediatric patients. We report a rare case of suprasellar germinoma presenting with SCFE in an 11-year-old female patient. The findings of this case further support the need to consider pituitary lesions as the underlying cause of endocrine deficiences leading to SCFE.