Simultaneous Development of Graves ’ Disease and Type 1 Diabetes during Anti‐programmed Cell Death‐1 Therapy: A Case Report

We present the first case of simultaneous development of Graves ’ disease and type 1 diabetes during anti‐programmed cell death 1 (PD‐1) therapy. A 48‐year‐old man with parotid gland adenocarcinoma and lung metastasis had received 5 courses of nivolumab. Fourteen days after administration of the 6th course, his casual plasma glucose and hemoglobin A1c levels were 379  mg/dL and 7.2%, respectively. Moreover, thyrotoxicosis was detected with a blood test. Serum total ketone body and thyroid‐stimulating hormone receptor antibody levels increased, and serum C‐peptide level decreased to 0.01 ng/mL thereafter. Thus, we concluded that he simultaneously developed anti‐PD‐1 therapy‐associated type 1 diabetes and Graves’ disease. Among Japanese participants with autoimmune polyglandular syndrome type III, the frequency of human leukocyte antigen (HLA)‐DRB1*04:05 is higher in those with both type 1 diabetes and Graves’ disease. Our case had HLA‐DR B1*04:05, which might be associated with the simultaneous development of the two diseases.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: CASE REPORT Source Type: research