Ren Yaoyao, Zhang Linlin, Wang Yu, Zhong Diansheng
Department of Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhongguo Fei Ai Za Zhi. 2022 Jan 20;25(1):61-65. doi: 10.3779/j.issn.1009-3419.2021.102.54.
Immune checkpoint inhibitors (ICIs) are widely used in clinic, and the incidence of rare adverse events are increasing. The aim of this paper is to better define the rare adverse effect of diabetes mellitus associated with ICIs. We report 2 cases of diabetes mellitus associated with ICIs. Literature review was conducted and we discussed the clinical presentation, potential mechanisms and suggestions for optimal management. Two patients were both elderly women, case 1 had increased blood glucose after 7 months of using Durvalumab, and cases 2 had diabetic ketoacidosis after 6 weeks of using Pembrolizumab. Both patients were administered exogenous insulin to control blood glucose. Case 1 has been treated with Durvalumab until now and case 2 discontinued using of Pembrolizumab. HLA genotypes and other factors may explain the risk factors of diabetes associated with ICIs in some individuals. Diabetes mellitus associated with ICIs is an uncommon but potentially life-threatening endocrine system adverse event, which requires doctors to be vigilant. The patients who use ICIs need to monitor blood glucose. If they have hyperglycemia, endocrinologists should be asked to assist in diagnosis and treatment. .
免疫检查点抑制剂（ICIs）在临床上广泛应用，罕见不良事件的发生率正在上升。本文旨在更好地界定与ICIs相关的糖尿病这一罕见不良反应。我们报告了2例与ICIs相关的糖尿病病例。进行了文献综述，并讨论了临床表现、潜在机制及最佳管理建议。两名患者均为老年女性，病例1在使用度伐利尤单抗7个月后血糖升高，病例2在使用帕博利珠单抗6周后发生糖尿病酮症酸中毒。两名患者均接受外源性胰岛素治疗以控制血糖。病例1至今仍在接受度伐利尤单抗治疗，病例2停用了帕博利珠单抗。人类白细胞抗原（HLA）基因型及其他因素可能解释部分个体中与ICIs相关的糖尿病风险因素。与ICIs相关的糖尿病是一种罕见但可能危及生命的内分泌系统不良事件，需要医生保持警惕。使用ICIs的患者需要监测血糖。如果出现高血糖，应请内分泌科医生协助诊断和治疗。
