Characteristics and clinical course of type 1 diabetes mellitus related to anti-programmed cell death-1 therapy

被引：106

作者：

Baden, Megu Yamaguchi ^{[1
]}

Imagawa, Akihisa ^{[2
]}

Abiru, Norio ^{[3
]}

Awata, Takuya ^{[4
]}

Ikegami, Hiroshi ^{[5
]}

Uchigata, Yasuko ^{[6
]}

Oikawa, Yoichi ^{[7
]}

Osawa, Haruhiko ^{[8
]}

Kajio, Hiroshi ^{[9
]}

Kawasaki, Eiji ^{[10
]}

Kawabata, Yumiko ^{[5
]}

Kozawa, Junji ^{[1
]}

Shimada, Akira ^{[7
]}

Takahashi, Kazuma ^{[11
,12
]}

Tanaka, Shoichiro ^{[13
]}

Chujo, Daisuke ^{[9
]}

Fukui, Tomoyasu ^{[14
]}

Miura, Junnosuke ^{[15
]}

Yasuda, Kazuki ^{[16
]}

Yasuda, Hisafumi ^{[17
]}

Kobayashi, Tetsuro ^{[18
]}

Hanafusa, Toshiaki ^{[19
]}

Nagafuchi, Seiho ^{[20
]}

Okamoto, Masahide ^{[21
]}

Ogawa, Osamu ^{[22
]}

Itateyama, Emi ^{[23
]}

Ohtake, Hiroyuki ^{[24
]}

Hirota, Yushi ^{[25
]}

Tomoyasu, Masako ^{[26
]}

Nakajima, Yasushi ^{[27
]}

Yano, Seiichi ^{[28
]}

Ashida, Kenji ^{[28
]}

Kumagai, Ryo ^{[29
]}

Yagyu, Hiroaki ^{[29
]}

Koriyama, Nobuyuki ^{[30
]}

Fukui, Michiaki ^{[31
]}

Daikoku, Harumi ^{[32
]}

Asai, Shiko ^{[33
]}

Mochida, Akihiro ^{[34
]}

Okajima, Fumitaka ^{[35
]}

Takagi, Satoshi ^{[36
]}

Nagasawa, Kaoru ^{[37
]}

Taketomo, Yasunori ^{[38
]}

机构：

[1] Osaka Univ, Grad Sch Med, Dept Metab Med, Suita, Osaka, Japan

[2] Osaka Med Coll, Dept Internal Med 1, 2-7 Daigakucho, Takatsuki, Osaka 5698686, Japan

[3] Nagasaki Univ, Grad Sch Biomed Sci, Dept Endocrinol & Metab, Nagasaki, Japan

[4] Int Univ Hlth & Welf Hosp, Dept Diabet Endocrinol & Metab, Otawara, Tochigi, Japan

[5] Kindai Univ, Fac Med, Dept Endocrinol Metab & Diabet, Higashiosaka, Osaka, Japan

[6] Tokyo Womens Med Univ, Med Ctr East, Tokyo, Japan

[7] Saitama Med Univ, Sch Med, Dept Endocrinol & Diabet, Saitama, Japan

[8] Ehime Univ, Sch Med, Dept Lab Med, Toon, Ehime, Japan

[9] Natl Ctr Global Hlth & Med, Ctr Hosp, Dept Diabet Endocrinol & Metab, Tokyo, Japan

[10] Shin Koga Hosp, Ctr Diabet, Kurume, Fukuoka, Japan

[11] Iwate Prefectural Univ, Fac Nursing, Takizawa, Iwate, Japan

[12] Iwate Prefectural Univ, Grad Sch Nursing, Takizawa, Iwate, Japan

[13] Ai Home Clin Toshima, Tokyo, Japan

[14] Showa Univ, Sch Med, Div Diabet & Endocrinol, Dept Internal Med, Tokyo, Japan

[15] Tokyo Womens Med Univ, Sch Med, Ctr Diabet, Tokyo, Japan

[16] Natl Ctr Global Hlth & Med, Diabet Res Ctr, Dept Metab Disorder, Res Inst, Tokyo, Japan

[17] Kobe Univ, Grad Sch Hlth Sci, Dept Community Hlth Sci, Div Hlth Sci, Kobe, Hyogo, Japan

[18] Okinaka Mem Inst Med Res, Tokyo, Japan

[19] Sakai City Med Ctr, Sakai, Osaka, Japan

[20] Saga Univ, Fac Med, Saga, Japan

[21] Oita Univ, Oita, Japan

[22] Kameda Med Ctr, Kamogawa, Chiba, Japan

[23] Oita Red Cross Hosp, Oita, Japan

[24] Saitama Med Ctr, Kawagoe, Saitama, Japan

[25] Kobe Univ, Kobe, Hyogo, Japan

[26] Tokyu Hosp, Tokyo, Japan

[27] Nippon Med Coll Hosp, Tokyo, Japan

[28] Kyushu Univ, Fukuoka, Japan

[29] Mito Kyodo Gen Hosp, Mito, Ibaraki, Japan

[30] Kagoshima Med Ctr, Kagoshima, Japan

[31] Kyoto Prefectural Univ Med, Kyoto, Japan

[32] Showa Gen Hosp, Kodaira, Tokyo, Japan

[33] Kawasaki Municipal Tama Hosp, Kawasaki, Kanagawa, Japan

[34] Juntendo Univ, Urayasu Hosp, Tokyo, Japan

[35] Chiba Hokusoh Hosp, Nippon Med Sch, Inzai, Chiba, Japan

[36] Tokyo Womens Med Univ, Tokyo, Japan

[37] Toranomon Gen Hosp, Tokyo, Japan

[38] Kindai Univ, Higashiosaka, Osaka, Japan

来源：

DIABETOLOGY INTERNATIONAL | 2019年 / 10卷 / 01期

基金：

日本学术振兴会;

关键词：

Nivolumab; Pembrolizumab; Anti-PD-1; antibody; Fulminant type 1 diabetes; Type; 1; diabetes; Immune-checkpoint inhibitors; DIAGNOSTIC-CRITERIA; HLA-DR; FULMINANT; ONSET; SOCIETY; JAPAN; NIVOLUMAB; COMMITTEE; KETOACIDOSIS; CHILDREN;

D O I：

10.1007/s13340-018-0362-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims: We conducted a national survey to clarify the characteristics and clinical course of type 1 diabetes related to anti-programmed cell death-1 therapy. Methods: We analyzed the detailed data of 22 patients that were collected using a Japan Diabetes Society survey and a literature database search. Results: Among the 22 patients, 11 (50.0%) met the criteria for fulminant type 1 diabetes and 11 (50.0%) met the criteria for acute-onset type 1 diabetes. The average patient age was 63years. The mean duration between the date of the first anti-PD-1 antibody injection and development of type 1 diabetes was 155days and ranged from 13 to 504days. Flu-like symptoms, abdominal symptoms, and drowsiness were observed in 27.8, 31.6, and 16.7% patients, respectively. Mean standard deviation or median (first quartile-third quartile)glucose levels, HbA1c levels, urinary C-peptide immunoreactivity levels, and fasting serum C-peptide immunoreactivity levels were 617 +/- 248mg/dl, 8.1 +/- 1.3%, 4.1 (1.4-9.4) g/day, and 0.46 (0.20-0.70) ng/ml, respectively. Seventeen of 20 patients (85.0%) developed ketosis, and 7 of 18 patients (38.9%) developed diabetic ketoacidosis. Ten of 19 patients (52.6%) showed at least one elevated pancreatic enzyme level at the onset and two of seven patients showed this elevation before diabetes onset. Only one of 21 patients was anti-glutamic acid decarboxylase antibody positive. Conclusions: Anti-programmed cell death-1 antibody-related type 1 diabetes varies from typical fulminant type 1 diabetes to acute-onset type 1 diabetes. However, diabetic ketoacidosis was frequently observed at the onset of diabetes. An appropriate diagnosis and treatment should be provided to avoid life-threatening metabolic alterations.

引用

页码：58 / 66

页数：9

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