A Patient with Nivolumab-related Fulminant Type 1 Diabetes Mellitus whose Serum C-peptide Level Was Preserved at the Initial Detection of Hyperglycemia

Naoko Yamamoto; Yuya Tsurutani; Sho Katsuragawa; Haremaru Kubo; Takashi Sunouchi; Rei Hirose; Yoshitomo Hoshino; Masahiro Ichikawa; Tomoko Takiguchi; Hiroko Yukawa; Hitoshi Arioka; Jun Saitou; Tetsuo Nishikawa

doi:10.2169/internalmedicine.2780-19

CASE REPORTS

A Patient with Nivolumab-related Fulminant Type 1 Diabetes Mellitus whose Serum C-peptide Level Was Preserved at the Initial Detection of Hyperglycemia

Naoko Yamamoto, Yuya Tsurutani, Sho Katsuragawa, Haremaru Kubo, Takashi Sunouchi, Rei Hirose, Yoshitomo Hoshino, Masahiro Ichikawa, Tomoko Takiguchi, Hiroko Yukawa, Hitoshi Arioka, Jun Saitou, Tetsuo Nishikawa

Author information

Naoko Yamamoto
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Yuya Tsurutani
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Sho Katsuragawa
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Haremaru Kubo
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Takashi Sunouchi
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Rei Hirose
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Yoshitomo Hoshino
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Masahiro Ichikawa
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Tomoko Takiguchi
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Hiroko Yukawa
Department of Medical Oncology, Yokohama Rosai Hospital, Japan
Hitoshi Arioka
Department of Medical Oncology, Yokohama Rosai Hospital, Japan
Jun Saitou
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan
Tetsuo Nishikawa
Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan

Keywords: nivolumab, fulminant type 1 diabetes mellitus, anti-PD-1 antibody

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 19 Pages 2825-2830

DOI https://doi.org/10.2169/internalmedicine.2780-19

Browse “Advance online publication” version

Details

Abstract

A 77-year-old-man with renal cell carcinoma who was undergoing nivolumab treatment visited our department due to hyperglycemia; his plasma glucose level was 379 mg/dL. Although his serum C-peptide immunoreactivity (CPR) level was preserved (5.92 ng/mL), we suspected an onset of fulminant type 1 diabetes mellitus (FT1DM) and immediately started insulin therapy. His CPR levels gradually decreased and were depleted within 1 week. We later discovered that the patient's casual CPR level had been abnormally high (11.78 ng/mL) 2 weeks before his admission. Hence, the possibility of FT1DM in hyperglycemic patients undergoing nivolumab treatment should not be excluded, even with a preserved CPR level.

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