Characterization of the onset of thyroid function (TF) abnormalities in patients receiving immune checkpoint inhibitor (CPI) therapy.

Elnair, Radowan; Chang, Guy Vin; Sethi, Prince; Abdullah, Hafez Mohammad Ammar; Zhao, Jing; Griebeler, Marcio L.; Powell, Steven

doi:10.1200/jco.2018.36.15_suppl.e22082

Cited by 1 publication

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“…Being an immunotherapeutic agent, it has been known to cause immune related adverse events (irae), including endocrinopathies like thyroiditis, diabetes mellitus, hypophysitis and adrenal insufficiency. Other adverse effects include colitis, hepatitis, nephritis, pneumonitis and encephalitis 1 2. Autoimmune diabetes mellitus has been reported in many case series and retrospective reviews, but there are increasing reports of life threating DKA due to acute onset of fulminant diabetes in patients receiving nivolumab 3.…”

Section: Introductionmentioning

confidence: 99%

Rapid onset type-1 diabetes and diabetic ketoacidosis secondary to nivolumab immunotherapy: a review of existing literature

Abdullah¹,

Elnair

Khan

et al. 2019

BMJ Case Rep

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Nivolumab is a programmed cell death receptor (PD-1) inhibitor that is increasingly used for various malignancies, both as a first line agent and as salvage therapy. Being a PD-1/PD-1 ligand checkpoint inhibitor, it is known to cause autoimmune inflammation of various organs and has been associated with thyroiditis, insulitis, colitis, hepatitis and encephalitis to name a few. There are increasing reports of nivolumab leading to acute onset fulminant type 1 diabetes and diabetic ketoacidosis (DKA). We present a case of a 68-year-old man who developed DKA after 2 doses of nivolumab for metastatic melanoma. He was found to have type 1 diabetes, but no diabetes related antibodies were positive. He recovered from diabetes and continues to use insulin 1 year after his diagnosis. This case and associated review illustrates the importance of educating and monitoring patients who start nivolumab therapy regarding this potentially life threatening complication.

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Section: Introductionmentioning

confidence: 99%