Immune ‐mediated diabetes due to pembrolizumab

Abstract Melanoma is one of the most commonly occurring skin cancers in the UK. As recommended by NICE, there are a number of drugs available to treat melanoma and immunotherapeutic drugs are widely used to improve survival in metastatic melanoma. Monoclonal antibodies can cause immune‐related side effects, including diabetes. Pembrolizumab, an anti‐programmed cell death‐1 receptor monoclonal antibody (PD‐1 Ab), was given to a 63‐year‐old woman with metastatic melanoma. She developed osmotic symptoms with tiredness and confusion after pembrolizumab treatment cycles. She was diagnosed with diabetic ketoacidosis; she was treated with intravenous insulin and started on insulin to control her hyperglycaemia. Endocrine immune‐related side effects are common with immunotherapeutic agents, especially anti‐cytotoxic T‐lymphocyte associated protein‐4 monoclonal antibody (anti‐CTLA‐4) and PD‐1 Abs. They mainly affect thyroid, pituitary and adrenal glands. Immune‐related diabetes is a rare side effect of immunotherapeutic agents. Therefore, clinical suspicion for immune‐related diabetes should be high in patients who are treated with these immunotherapeutic agents. Copyright © 2017 John Wiley & Sons.
Source: Practical Diabetes - Category: Endocrinology Authors: Tags: Case report Source Type: research