Fulminant Type 1 Diabetes Mellitus 17 Months after Initiation of Immune Checkpoint Inhibitors

DOI
  • Watanabe Tomomi
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Harai Nozomi
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Saegusa Natsumi
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Inukai Takahiko
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Hosokawa Tadatsugu
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Antoku Airi
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Muroi Yuko
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Hayashida Ryosuke
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital
  • Tsuchiya Kyoichiro
    Department of Diabetes and Endocrinology, University of Yamanashi Hospital

Bibliographic Information

Other Title
  • 免疫チェックポイント阻害薬開始から1年5カ月後に発症した劇症1型糖尿病の1例

Abstract

<p>A 66-year-old man had been treated with nivolumab and ipilimumab for non-squamous cell carcinoma of the lung since May X−1. In October Y−7, X, his blood glucose level and blood C-peptide were 147 mg/dL and 1.76 ng/mL, respectively. In October Y, he visited the emergency room with complaints of dry mouth, polydipsia, nausea, and decreased appetite. His blood glucose level and blood C-peptide were 1,684 mg/dL and 0.09 ng/mL, respectively, and he had ketoacidosis, which was diagnosed as diabetic ketoacidosis due to fulminant type 1 diabetes associated with immune checkpoint inhibitors. This case is unique in that the onset of DKA occurred 17 months after administration. The insulin secretory capacity was maintained one week before the onset of the disease, and it was confirmed that this capacity decreased rapidly. Based on this experience, we held a case conference, revised the in-hospital algorithm for immune-related adverse events, prepared a manual for reverse engineering, conducted educational activities for patients, and shared the information with physicians. We report the activities of our hospital in this study.</p>

Journal

Keywords

Details 詳細情報について

  • CRID
    1390298355901367936
  • DOI
    10.11213/tonyobyo.66.783
  • ISSN
    1881588X
    0021437X
  • Text Lang
    ja
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

Report a problem

Back to top