Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, China.
Front Public Health. 2022 Jun 16;10:917679. doi: 10.3389/fpubh.2022.917679. eCollection 2022.
Immune checkpoint inhibitors, widely used in the treatment of malignancies, can improve the prognosis of patients, while it also can induce various immune-related adverse events, and type 1 diabetes induced by anti-programmed cell death protein-1 is a rare but severe complication. Here we reported a case of type 1 diabetes induced by anti-PD-1 which was to treat intrahepatic cholangiocarcinoma. The case was a 61-year-old female who developed diabetes and ketoacidosis symptoms at the 16th week after anti-PD-1 therapy. Her blood glucose was 30.32 mmol/L, HBA1c was 8.10%, and C-peptide was <0.10 ng/ml. The patient was diagnosed as fulminant type 1 diabetes mellitus complicated with ketoacidosis induced by anti-PD-1, and was treated with massive fluid rehydration, intravenous infusion of insulin and correction of acid-base electrolyte disorder. Hepatectomy was performed after stabilization, and the patient was treated with long-term insulin. Through the case report and literature review, this study aims to improve oncologists' understanding of anti-PD-1 induced type 1 diabetes, so as to make early diagnosis and treatment of the complications and ensure medical safety.
免疫检查点抑制剂广泛用于治疗恶性肿瘤，可以改善患者的预后，但也会引发各种免疫相关不良反应，抗程序性细胞死亡蛋白-1 引起的 1 型糖尿病就是一种罕见但严重的并发症。本文报道了 1 例抗 PD-1 治疗肝内胆管细胞癌后发生的 1 型糖尿病病例。该病例为 61 岁女性，在抗 PD-1 治疗后第 16 周出现糖尿病酮症酸中毒症状。患者血糖为 30.32mmol/L，糖化血红蛋白 8.10%，C 肽<0.10ng/ml。诊断为抗 PD-1 致 1 型糖尿病、糖尿病酮症酸中毒，给予大量补液、静脉滴注胰岛素及纠正酸碱电解质紊乱治疗。病情稳定后行肝切除术，患者长期接受胰岛素治疗。通过病例报告和文献复习，旨在提高肿瘤医生对抗 PD-1 引起 1 型糖尿病的认识，以便对并发症做到早期诊断和治疗，保证医疗安全。
