Department of Endocrinology and Diabetes, Saitama Medical University International Medical Center, Saitama, Japan.
Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan.
J Diabetes Investig. 2020 Jul;11(4):1006-1009. doi: 10.1111/jdi.13212. Epub 2020 Feb 16.
We present the first case of simultaneous development of Graves' disease and type 1 diabetes during anti-programmed cell death 1 therapy. A 48-year-old man with parotid gland adenocarcinoma and lung metastasis had received five courses of nivolumab. Fourteen days after administration of the sixth course, his casual plasma glucose and hemoglobin A1c levels were 379 mg/dL and 7.2%, respectively. Furthermore, thyrotoxicosis was detected with a blood test. Serum total ketone body and thyroid-stimulating hormone receptor antibody levels increased, and serum C-peptide level decreased to 0.01 ng/mL thereafter. Thus, we concluded that he simultaneously developed anti-programmed cell death 1 therapy-associated type 1 diabetes and Graves' disease. Among Japanese patients with autoimmune polyglandular syndrome type III, the frequency of human leukocyte antigen-DRB104:05 is higher in those with both type 1 diabetes and Graves' disease. Our case had human leukocyte antigen-DRB104:05, which might be associated with the simultaneous development of the two diseases.
我们报告了首例抗程序性细胞死亡蛋白 1 治疗期间同时发生 Graves 病和 1 型糖尿病的病例。一名 48 岁男性患有腮腺腺癌和肺转移，已接受了五轮纳武利尤单抗治疗。第六轮治疗后 14 天，他的随机血浆葡萄糖和糖化血红蛋白水平分别为 379mg/dL 和 7.2%。此外，通过血液检查发现甲状腺功能亢进。血清总酮体和促甲状腺激素受体抗体水平升高，此后血清 C 肽水平降至 0.01ng/mL。因此，我们得出结论，他同时发生了抗程序性细胞死亡蛋白 1 治疗相关的 1 型糖尿病和 Graves 病。在日本自身免疫多腺体综合征 III 型患者中，同时患有 1 型糖尿病和 Graves 病的患者人类白细胞抗原-DRB104:05 的频率更高。我们的病例存在人类白细胞抗原-DRB104:05，这可能与两种疾病的同时发生有关。
