Case Report
Fulminant Diabetes in a Patient with Advanced Melanoma on Nivolumab
Table 1
Characteristics of patients reported in the literature so far with fulminant diabetes from anti-PD-1 immunotherapy.
| Study | Age (years)/sex | Cancer diagnosis | Anti-PD-1 agent | Presentation | HbA1C (%) | C-peptide | Antibody positivity |
| Hughes et al. [7] | 55/F | Melanoma | Nivolumab | DKA | 6.9 | Undetectable | No | 83/F | NSCLC | Nivolumab | DKA | 7.7 | Undetectable | GADA | 63/M | RCC | Nivolumab | Hyperglycemia | 8.2 | Low | GADA, IAA, ICA | 58/M | SCLC | Nivolumab | DKA | 9.7 | Undetectable | GADA | 64/F | Melanoma | Pembrolizumab | Hyperglycemia | 7.4 | Low | No | Martin-Liberal et al. [8] | 54/F | Melanoma | Pembrolizumab | DKA | NA | NA | GADA | Mellati et al. [9] | 70/M | NSCLC | Nivolumab | DKA | 9.8 | Low | NA | 66/F | Jaw sarcomatoid squamous cell carcinoma | NA | DKA | 9.4 | Undetectable | GADA | Gaudy et al. [10] | 44/F | Melanoma | Pembrolizumab | DKA | 6.85 | Undetectable | GADA | Okamoto et al. [11] | 55/F | Melanoma | Nivolumab | Hyperglycemia | 7 | Undetectable | No | Miyoshi et al. [5] | 66/F | Melanoma | Nivolumab | DKA | 7.3 | Undetectable | No | Lowe et al. [12] | 54/F | Melanoma | Nivolumab | DKA | NA | Undetectable | GADA | Munakata et al. [13] | 71/M | Hodgkin lymphoma | Nivolumab | Hyperglycemia | 7.3 | Undetectable | No | Ishikawa et al. [14] | 54/F | Melanoma | Nivolumab | DKA | 7 | Low | No | Li et al. [15] | 63/F | NSCLC | Nivolumab | DKA | <6.4% | NA | GADA | Araújo et al. [16] | 73/F | NSCLC | Nivolumab | DKA | 7.2 | Undetectable | GADA | Alzenaidi et al. 2017 [17] | 47/M | Melanoma | Nivolumab | DKA | 8 | Undetectable | GADA | Godwin et al. [18] | 34/F | NSCLC | Nivolumab | DKA | 7.1 | Undetectable | GADA, IA-2, IAA | This study | 61/M | Melanoma | Nivolumab | DKA | 6.9 | Undetectable | No |
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DKA: diabetic ketoacidosis; F: female; NSCLC: nonsmall cell lung cancer; SCLC: small cell lung cancer; RCC: renal cell carcinoma; GADA: glutamic acid decarboxylase autoantibodies; IAA: insulin autoantibodies; ICA: islet cell antibodies; NA: not available; IA-2: islet 2 autoantibody.
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