Galligan A, Xu W, Fourlanos S, Nankervis A, Chiang C, Mant AM, Parente P, Rischin D, Krishnamurthy B, Sandhu S, Colman PG. Diabetes associated with immune checkpoint inhibition: presentation and management challenges.
Diabet Med 2018;
35:1283-1290. [PMID:
29908076 DOI:
10.1111/dme.13762]
[Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND
In recent years, immune checkpoint blockade has become a standard therapy for a wide range of cancers. Adverse events including endocrinopathies result from the induction of autoimmunity.
CASE REPORT
We report a case series of nine individuals who presented with immunotherapy-induced type 1 diabetes between 2015-2017.
DISCUSSION
Onset of diabetes occurred within 12 weeks of commencing therapy. Anti- GAD antibodies were present in six people. Retrospective testing of islet antibodies in pre-treatment samples was possible in two people and this revealed anti-GAD seroconversion in the first and high anti-GAD titres pre and post-treatment in the second person. Six people had high risk HLA haplotypes. Clinical and genetic factors are described and compared with previously published cases. This article is protected by copyright. All rights reserved.
Collapse