Abstract：-An 82-year-old female patient received monotherapy with nivolumab (240-mg by an IV infusion on the firsr day, 14 days as a cycle) because of multiple metastases of central adenocarcinoma in the right upper lobe of the lung. After 8 cycles of immunotherapy (about 4 months), the patient developed severe nausea and vomiting. Laboratory tests showed random blood glucose 43.2-mmol/L and β-hydroxybutyric acid 5.3-mmol/L. Blood gas analysis showed pH 7.01, bicarbonate root 4.0-mmol/L, alkali residual -22.4-mmol/L, serum potassium 6.1-mmol/L, and lactic acid 2.9-mmol/L. The patient had no previous history of diabetes mellitus. Fulminant type 1 diabetes mellitus due to nivolimab was considered. Nivolumab was stopped and rehydration, hypoglycemia, acidosis correction, and other symptomatic treatments were given. Two days later, her symptoms were improved obviously. Laboratory tests showed fasting plasma glucose 15.8-mmol/L and β-hydroxybutyric acid 0.2-mmol/L. Blood gas analysis showed pH 7.39, bicarbonate root 21.2-mmol/L, alkali residual -3.8-mmol/L, serum potassium 4.3-mmol/L, and lactic acid 1.0-mmol/L.
王蘇弘，程妍，杨茂光，何扬芳，沈鸿，蔡寒青. 纳武利尤单抗致暴发性1型糖尿病[J]. 药物不良反应杂志, 2021, 23(8): 436-438.
Wang Suhong, Cheng Yan, Yang Maoguang, He Yangfang, Shen Hong, Cai Hanqing. Fulminant type 1 diabetes mellitus caused by nivolumab. Adverse Drug Reactions Journal, 2021, 23(8): 436-438.
