Yang J, Wang Y, Tong XM. Sintilimab-induced autoimmune diabetes: A case report and review of the literature. World J Clin Cases 2022; 10(4): 1263-1277 [PMID: 35211559 DOI: 10.12998/wjcc.v10.i4.1263]
Corresponding Author of This Article
Xiang-Min Tong, MD, PhD, Chief Physician, Department of Hematology, Clinical Trial Institute, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. tongxiangmin@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2022; 10(4): 1263-1277 Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1263
Sintilimab-induced autoimmune diabetes: A case report and review of the literature
Jing Yang, Ying Wang, Xiang-Min Tong
Jing Yang, Clinical Laboratory Center, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Ying Wang, Clinical Research Institute, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Xiang-Min Tong, Department of Hematology, Clinical Trial Institute, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Yang J contributed to data curation; Tong XM and Wang Y contributed to project administration and resources; Yang J wrote the first draft; Tong XM reviewed and edited the manuscript.
Supported byKey Research and Development Project of Science and Technology Department of Zhejiang Province, No. 2019C03038.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang-Min Tong, MD, PhD, Chief Physician, Department of Hematology, Clinical Trial Institute, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. tongxiangmin@163.com
Received: April 15, 2021 Peer-review started: April 15, 2021 First decision: July 6, 2021 Revised: July 8, 2021 Accepted: September 8, 2021 Article in press: September 8, 2021 Published online: February 6, 2022
Abstract
BACKGROUND
With the widespread application of immune checkpoint inhibitor (ICI) therapy, the number of immune-related adverse effects (irAEs) has increased over the years. Autoimmune diabetes mellitus (DM) is a rare irAEs of ICIs and can be troublesome and life threatening.
CASE SUMMARY
We report a 78-year-old woman with no history of diabetes who presented with hyperglycemia up to 23.4 mmol/L (random blood glucose level) after 14 courses of sintilimab. Hemoglobin A1c was 8.2%, fasting insulin was 0.29 mIU/mL, and fasting C-peptide was decreased to a level with negative autoantibodies. Combing her medical history and laboratory examination, she was diagnosed with programmed cell death (PD)-1-inhibitor-induced, new-onset autoimmune DM. After controlling her blood glucose, she was treated with daily insulin by subcutaneous injection. She was allowed to continue anti-PD-1 therapy and she still obtained some therapeutic efficacy. We also reviewed some published cases (n = 36) of PD-1/PD-ligand 1 (PD-L1) inhibitor-induced DM. We also discuss potential pathogenic mechanisms, clinical features, prognostic markers (β cell antibodies, human leukocyte antigen type, PD-L1 Level) of this rare adverse effect.
CONCLUSION
It is important for all clinicians to be aware of DM as an irAEs of ICIs.
Core tip: We report a case of programmed cell death (PD)-1-inhibitor-induced autoimmune diabetes mellitus (DM) after treatment of small cell lung cancer, and reviewed some published cases (n = 36) of PD-1/PD-ligand 1 inhibitor-induced DM. Plasma glucose monitoring is significant for preventing the occurrence of diabetic ketoacidosis.
