摘要
收集2020年1月至2022年10月于中南大学湘雅二医院就诊的10例免疫检查点抑制剂相关1型糖尿病患者的临床资料,男9例,女1例,年龄(57±8)岁,其中暴发性1型糖尿病7例,急性1型糖尿病3例。10例中肺癌5例,食管癌2例,胃癌、肾细胞癌、鼻咽癌各1例。10例患者所使用的药物均为程序性细胞死亡受体1抑制剂,其中派姆单抗5例,信迪利单抗3例,替雷珠单抗1例,特瑞普利单抗1例。其中8例以糖尿病酮症酸中毒起病,1例以糖尿病酮症起病,1例起病时无酮症;9例胰岛相关抗体阴性,另1例阳性。10例均获得成功救治,且依赖胰岛素治疗。免疫检查点抑制剂可导致1型糖尿病,包括暴发性1型糖尿病,多以糖尿病酮症酸中毒起病,需要早期识别,积极胰岛素治疗。
The clinical data of ten patients with immune checkpoint inhibitor-related type 1 diabetes mellitus were enrolled in the Second Xiangya Hospital of Central South University from January 2020 to October 2022 including 9 males and 1 female,with an average age of(57±8)years.There were 7 cases of fulminant type 1 diabetes and 3 cases of acute type 1 diabetes.Among the 10 patients,there were 5 cases of lung cancer,2 cases of esophageal cancer,1 case of gastric carcinom,1 case of renal cell carcinoma,and 1 case of nasopharyngeal cancer.The drugs used in 10 patients were all programmed cell death receptor 1(PD-1)inhibitors,including 5 cases of pembrolizumab,3 cases of sintilimab,1 case of tanezumab,and 1 case of toripalimab.Among them,8 patients had diabetic ketoacidosis(DKA),1 patient had ketosis,and 1 case had no ketosis at onset;9 patients were negative for diabetes-related antibodies,and 1 patient was positive.All the 10 patients were successfully treated and depended on insulin therapy.Immune checkpoint inhibitors can cause type 1 diabetes,including fulminant type 1 diabetes,which mostly begins with DKA,requiring early identification and aggressive insulin therapy.
作者
邱俊霖
罗说明
殷文凤
李霞
周智广
Qiu Junlin;Luo Shuoming;Yin Wenfeng;Li Xia;Zhou Zhiguang(Department of Metabolism and Endocrinology,the Second Xiangya Hospital of Central South University,Key Laboratory of Diabetes Immunology(Central South University),Ministry of Education,National Clinical Research Center for Metabolic Diseases,Changsha,410011 China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第1期38-41,共4页
National Medical Journal of China
基金
湖南省卫生健康委重点资助课题(202103060904)
关键词
糖尿病
1型
免疫检查点抑制剂
程序性细胞死亡受体1
临床特征
Diabetes mellitus,type 1
Immune checkpoint inhibitor
Programmed cell death protein 1
Clinical characteristics
作者简介
通信作者:罗说明,Email:shuomingluo@csu.edu.cn
