Acute Exacerbation of Type 1 Diabetes and Transient Thyrotoxicosis Around the Same Time After Anti-PD-1 Antibody Administration in a Lung Cancer Patient
The patient was a 65-year-old man who had been diagnosed with diabetes 3 years previously. An examination revealed an HbA1c level of 10.6 %, which improved to approximately 6 % with diet and exercise therapy. The patient underwent surgery and received chemotherapy for his lung cancer, but mediastina...
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Published in | Journal of the Japan Diabetes Society Vol. 63; no. 11; pp. 746 - 753 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
THE JAPAN DIABETES SOCIETY
30.11.2020
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Online Access | Get more information |
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Summary: | The patient was a 65-year-old man who had been diagnosed with diabetes 3 years previously. An examination revealed an HbA1c level of 10.6 %, which improved to approximately 6 % with diet and exercise therapy. The patient underwent surgery and received chemotherapy for his lung cancer, but mediastinal lymphadenopathy remained. Thus, pembrolizumab, an anti-programmed cell death-1 (PD-1) antibody, was administered. Two months later, steroids were administered for suspected bronchial asthma. The following day, he was admitted due to diabetic ketoacidosis. His anti-glutamic acid decarboxylase (GAD) antibody level was 9.7 U/mL. One month previously, his HbA1c, casual blood glucose, and blood C-peptide immunoreactivity were 6.7 %, 121 mg/dL, and 1.9 ng/mL, respectively. Serum collected prior to anti-PD-1 antibody administration was positive for anti-GAD, anti-thyroglobulin, and anti-thyroid peroxidase antibodies. In this patient with slowly progressive type 1 diabetes accompanied by Hashimoto's disease, the patient's diabetes was acutely exacerbated and thyrotoxicosis occurred around the same time after the administration of anti-PD-1 antibody. This case brings attention to the importance of the early diagnosis and treatment of diabetic ketoacidosis. |
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ISSN: | 0021-437X 1881-588X |
DOI: | 10.11213/tonyobyo.63.746 |