Sintilimab-induced autoimmune diabetes: A case report and review of the literature.
World J Clin Cases
; 10(4): 1263-1277, 2022 Feb 06.
Article
in En
| MEDLINE
| ID: mdl-35211559
ABSTRACT
BACKGROUND:
With the widespread application of immune checkpoint inhibitor (ICI) therapy, the number of immune-related adverse effects (irAEs) has increased over the years. Autoimmune diabetes mellitus (DM) is a rare irAEs of ICIs and can be troublesome and life threatening. CASESUMMARY:
We report a 78-year-old woman with no history of diabetes who presented with hyperglycemia up to 23.4 mmol/L (random blood glucose level) after 14 courses of sintilimab. Hemoglobin A1c was 8.2%, fasting insulin was 0.29 mIU/mL, and fasting C-peptide was decreased to a level with negative autoantibodies. Combing her medical history and laboratory examination, she was diagnosed with programmed cell death (PD)-1-inhibitor-induced, new-onset autoimmune DM. After controlling her blood glucose, she was treated with daily insulin by subcutaneous injection. She was allowed to continue anti-PD-1 therapy and she still obtained some therapeutic efficacy. We also reviewed some published cases (n = 36) of PD-1/PD-ligand 1 (PD-L1) inhibitor-induced DM. We also discuss potential pathogenic mechanisms, clinical features, prognostic markers (ß cell antibodies, human leukocyte antigen type, PD-L1 Level) of this rare adverse effect.CONCLUSION:
It is important for all clinicians to be aware of DM as an irAEs of ICIs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Prognostic_studies
Language:
En
Journal:
World J Clin Cases
Year:
2022
Document type:
Article
Affiliation country:
China