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

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.