Pembrolizumab-Induced Diabetes Mellitus Presenting as Diabetic Ketoacidosis in a Patient With Metastatic Colonic Adenocarcinoma. J Investig Med High Impact Case Rep 2020;8:2324709620951339
Date
08/25/2020Pubmed ID
32830561Pubmed Central ID
PMC7448133DOI
10.1177/2324709620951339Scopus ID
2-s2.0-85089794503 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
Immunotherapy drugs are gaining popularity in the treatment of certain malignancies due to the success of these agents in recent clinical trials. Pembrolizumab is an immune checkpoint inhibitor that acts via binding to programmed cell death 1 (PD-1) receptors on T-cells, allowing for the constitutive activation of T-cells to fight malignant tumor cells. Immune checkpoint molecules such as PD-1 act to inhibit T-cell function, promoting tolerance to self-antigens. Inhibition of these molecules may lead to increased T-cell activation against cancer cells, but also against healthy tissue, leading to the side effects of these medications known as immune-related adverse events. In this article, we present the case of a 77-year-old female with a history of metastatic colonic adenocarcinoma presenting with new-onset diabetes mellitus and diabetic ketoacidosis in the setting of receiving pembrolizumab chemotherapy. Our patient was treated with hydration, insulin therapy, and management of her electrolytes, ultimately being discharged with the need for home insulin therapy to manage her new-onset diabetes. There are no current guidelines for the management or surveillance of patients receiving pembrolizumab chemotherapy, and further research should be done to determine which patients are at highest risk to developing this rare but potentially lethal side effect.
Author List
Kichloo A, Albosta MS, McMahon S, Movsesian K, Wani F, Jamal SM, Aljadah M, Singh JAuthor
Michael M. Aljadah MD Instructor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdenocarcinomaAged
Antibodies, Monoclonal, Humanized
Antineoplastic Agents, Immunological
Colonic Neoplasms
Diabetic Ketoacidosis
Female
Humans
Immunotherapy
Programmed Cell Death 1 Receptor
