长期使用尼沃单抗潜在毒性对1型糖尿病的影响

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM
Diabetology International Pub Date : 2023-08-28 eCollection Date: 2024-01-01 DOI:10.1007/s13340-023-00659-5
Yuma Motomura, Shin Urai, Yushi Hirota, Naoki Takegawa, Hironori Bando, Masaaki Yamamoto, Hidenori Fukuoka, Masahiro Tsuda, Wataru Ogawa
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引用次数: 0

摘要

我们报告了一例 1 型糖尿病(T1DM)病例,患者是一名 53 岁的男性,在长期接受 nivolumab 治疗后发病。患者在 40 岁时因胃癌接受了全胃切除术,48 岁时开始使用尼妥珠单抗治疗对标准化疗耐药的复发病灶。Nivolumab 治疗后患者获得了完全应答,但在 53 岁时第 136 次输注药物后,患者因突发糖尿病酮症酸中毒而住院治疗。他被诊断为免疫检查点抑制剂诱发的 T1DM(ICI-DM),在开始使用 nivolumab 后的 1988 天(284 周)发病。HLA分型发现了暴发性T1DM和ICI-DM的疾病易感等位基因。随着 ICI 治疗后存活率的提高,有报道称长期使用 ICI 后会出现迟发性 irAEs,但迟发性 ICI-DM 仍有待阐明。本病例对长期服用 ICI 后出现的 ICI-DM 提供了重要的见解,并提示无论 ICI 治疗时间长短,都应监测患者是否出现 ICI-DM。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Type 1 diabetes mellitus affected by potential toxicity from long-term use of nivolumab.

We present a case of type 1 diabetes mellitus (T1DM) that developed in a 53-year-old man after long-term treatment with nivolumab. The patient underwent total gastrectomy for gastric cancer at 40 years of age, and he was started on nivolumab at age 48 years for treatment of a recurrent lesion that proved resistant to standard chemotherapy. Nivolumab treatment resulted in complete response, but, after the 136th infusion of the drug at age 53 years, the patient was hospitalized for sudden onset of diabetic ketoacidosis. He was diagnosed with immune checkpoint inhibitor-induced T1DM (ICI-DM), which developed 1988 days (284 weeks) after initiation of nivolumab. HLA typing revealed disease susceptibility alleles for both fulminant T1DM and ICI-DM. With the increased survival after the ICI treatment, delayed-onset irAEs after long-term use of ICI have been reported; however, delayed-onset ICI-DM remains to be elucidated. This case provides important insight into ICI-DM that develops after prolonged ICI administration, and it suggests that patients should be monitored for ICI-DM regardless of the duration of ICI therapy.

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来源期刊
Diabetology International
Diabetology International ENDOCRINOLOGY & METABOLISM-
CiteScore
3.90
自引率
4.50%
发文量
42
期刊介绍: Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
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