Nivolumab, an Anti-Programmed Cell Death-1 Antibody, Induces Fulminant Type 1 Diabetes.

摘要: Programmed cell death-1 (PD-1), an immunoreceptor, is located on T cells and pro-B interacts with its ligands to inhibit activation proliferation, thereby promoting immunological self-tolerance. Nivolumab, anti-PD1 antibody, blocks PD-1 can restore anticancer immune responses by abrogating pathway-mediated T-cell inhibition. Autoimmune adverse events are expected therapy. Fulminant type 1 diabetes the subtype of diabetes. The clinical feature extremely rapid progression hyperglycemia ketoacidosis. Here we describe a 66-year-old woman advanced melanoma who was treated nivolumab. After 4 months six doses medicine, patient admitted hospital complaints nausea vomiting. laboratory data showed ketonuria, (531 mg/dl), high anion gap metabolic acidosis, HbA1c (7.3%), absence insulin-secreting capacity. These compatible criteria fulminant diagnosed diabetic ketoacidosis because findings this case indicated that nivolumab cause Diabetic due potentially fatal condition. Thus, should be considered in differential diagnosis when patients complain gastrointestinal symptoms.