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Acta Diabetologica

, Volume 53, Issue 5, pp 853–856 | Cite as

Anti-programmed cell death 1 therapy triggering diabetic ketoacidosis and fulminant type 1 diabetes

  • Sung Hye Kong
  • Seo Young Lee
  • Ye Seul Yang
  • Tae Min Kim
  • Soo Heon KwakEmail author
Case Report

Introduction

Programmed cell death 1 (PD-1) is a co-inhibitory molecule expressed on effector T cells and is involved in regulation of immune checkpoints. One of the known ligands of PD-1 protein is programmed cell death ligand 1 (PDL-1), which is expressed in many tumor cells. Activation of PD-1/PDL-1 axis results in suppression of anti-tumor immune checkpoints. Pembrolizumab is an immunoglobulin G4 monoclonal antibody targeting PD-1 molecule that increases immune response and induces anti-tumor activity. It has been approved for treating metastatic melanoma and is currently on clinical investigation for several other tumors including non-small cell lung cancer. On the other hand, PD-1 or PDL-1 blockade induced type 1 diabetes mellitus (T1DM) in non-obese prediabetic mice regardless of age [1]. In humans, few case reports of anti-PD-1 therapy induced T1DM have been reported including one case of fulminant T1DM [2, 3]. Here, we described a case of new-onset fulminant T1DM after...

Keywords

Chronic Pancreatitis Glimepiride Diabetic Ketoacidosis Immune Checkpoint Subclinical Hyperthyroidism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (IRB No. 1508-041-694) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

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    Tsutsumi C, Imagawa A, Ikegami H et al (2012) Class II HLA genotype in fulminant type 1 diabetes: a nationwide survey with reference to glutamic acid decarboxylase antibodies. J Diabetes Investig 3(1):62–69. doi: 10.1111/j.2040-1124.2011.00139.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • Sung Hye Kong
    • 1
    • 2
  • Seo Young Lee
    • 1
    • 2
  • Ye Seul Yang
    • 1
    • 2
  • Tae Min Kim
    • 1
    • 2
  • Soo Heon Kwak
    • 1
    • 2
    Email author
  1. 1.Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
  2. 2.Department of Internal MedicineSeoul National University HospitalSeoulKorea

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