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Diabetic Ketoacidosis Secondary to New Onset Type 1 Diabetes Mellitus Related to Pembrolizumab Therapy

机译:糖尿病酮症中的第二发起型1型糖尿病患者与彭洛丽撒疗法有关

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Pembrolizumab is an immunoglobulin G4 (IgG4) monoclonal antibody used in the treatment of various types of cancers.?Despite its efficacy, pembrolizumab does not specifically target cancer cells which often leads to common side effects seen in immunotherapies such as diarrhea, rash, fatigue, nausea, decreased appetite, pruritus, and endocrinopathies. Type 1 diabetes mellitus (T1DM) has been reported in 0.1% of the patients in pembrolizumab clinical trials. In this case report, we discuss a 65-year-old Caucasian male with a history of metastatic head and neck cancer that was previously treated with pembrolizumab and was subsequently admitted to the intensive care unit (ICU) due to new onset diabetic ketoacidosis (DKA).?Based on the timing of his presentation and the pre-hospital/inpatient workup, notably a normal hemoglobin A1C (HbA1c) 72 hours prior to admission and a significant increase thereafter, it was concluded that his presentation of diabetic ketoacidosis was secondary to his most recent infusion of pembrolizumab. With immunotherapies like programmed cell death (PD1) receptor antibodies becoming a more common first-line treatment for various cancers, this case hopes to raise awareness about the possible endocrinologic-related adverse events to its use and may help guide outpatient management.
机译:PEMBROLIZUAB是一种用于治疗各种类型的癌症的免疫球蛋白G4(IgG4)单克隆抗体。其疗效,PEMBROLIZUAB没有特别靶向癌细胞,这通常导致免疫检测中的常见副作用,例如腹泻,皮疹,疲劳,恶心,食欲减少,瘙痒和内分泌术。在Pembrolizumab临床试验中的0.1%的患者中报道了1型糖尿病(T1DM)。在本案中,我们讨论了一名65岁的白种人男性,其历史前后用彭布洛拉妥替纳瓦治疗,随后由于新的发病糖尿病酮症病症而被录取为重症监护单位(ICU)(DKA )。他最近输注彭洛米拉姆。具有类似于编程的细胞死亡(PD1)受体抗体的免疫疗法成为各种癌症的更常见的一线治疗,这种情况希望提高对可能的内分泌有关的不良事件的认识,并可以帮助导向门诊管理。

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