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Jehl A, Cugnet-Anceau C, Vigouroux C, Legeay AL, Dalle S, Harou O, Marchand L, Lascols O, Caussy C, Thivolet C, Laville M, Disse E. Acquired Generalized Lipodystrophy: A New Cause of Anti-PD-1 Immune-Related Diabetes. Diabetes Care 2019; 42:2008-2010. [PMID: 31434650 DOI: 10.2337/dc18-2535] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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] [Received: 12/11/2018] [Accepted: 06/29/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Anti-programmed cell death-1 (anti-PD-1) antibodies have revolutionized advanced cancer therapy. Anti-PD-1 therapy is responsible for immune-related adverse events, with frequent endocrine manifestations, including acute-onset type 1 diabetes. Acquired generalized lipodystrophy (AGL) is a rare disease, believed to be immune mediated, characterized by loss of adipose tissue and insulin resistance-associated complications. RESEARCH DESIGN AND METHODS We describe the first reported case of AGL induced by immune checkpoint therapy. RESULTS A 62-year-old woman with metastatic melanoma treated with nivolumab was referred for major hyperglycemia, hypertriglyceridemia, and nonalcoholic steatohepatitis. She had presented with a rapidly progressive generalized loss of subcutaneous adipose tissue. Diabetes was associated with severe insulin resistance and undetectable plasma leptin. Subcutaneous biopsy revealed atrophic adipose tissue infiltrated with cytotoxic CD8+ T lymphocytes and fibrosis. CONCLUSIONS AGL is an additional immune-related adverse event of anti-PD-1 therapy that leads to severe insulin resistance-associated complications.
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Affiliation(s)
- Alexandre Jehl
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France
| | - Christine Cugnet-Anceau
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France.,ImmuCare, Cancer Institute of Hospices Civils de Lyon, Lyon, France
| | - Corinne Vigouroux
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Department of Genetics and Molecular Biology and Department of Endocrinology, Reference Center of PRISIS, Paris, France.,Sorbonne University, INSERM UMR S938, Saint-Antoine Research Center (CRSA), Paris, France
| | - Anne L Legeay
- ImmuCare, Cancer Institute of Hospices Civils de Lyon, Lyon, France.,Dermatology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Stéphane Dalle
- ImmuCare, Cancer Institute of Hospices Civils de Lyon, Lyon, France.,Dermatology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Olivier Harou
- ImmuCare, Cancer Institute of Hospices Civils de Lyon, Lyon, France.,Anatomopathology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Lucien Marchand
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France
| | - Olivier Lascols
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Department of Genetics and Molecular Biology and Department of Endocrinology, Reference Center of PRISIS, Paris, France.,Sorbonne University, INSERM UMR S938, Saint-Antoine Research Center (CRSA), Paris, France
| | - Cyrielle Caussy
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France
| | - Charles Thivolet
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France
| | - Martine Laville
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France.,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France
| | - Emmanuel Disse
- French Network of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS) and FIRENDO Network, Paris and Lyon, France .,Endocrinology, Diabetology, and Nutrition Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,Lyon University, Université Claude Bernard Lyon 1, INSERM U1060, INRA 1397, INSA Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Lyon, France
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