PDF(Pubmed)
Abstract：
BACKGROUND: As a newly approved immune checkpoint inhibitor in China, serplulimab has been widely used in the immunotherapy of tumors. However, the immune-related adverse events of immune checkpoint inhibitors should not be ignored. Although immune checkpoint inhibitor-induced type 1 diabetes mellitus is a rare complication, it may cause diabetic ketoacidosis and endanger the lives of patients.
METHODS: This case report describes a 55-year-old male of Han nationality from China diagnosed with small-cell lung cancer with multiple metastases who experienced an adverse event of type 1 diabetes mellitus 68 weeks after receiving serplulimab therapy. The patient presented with typical symptoms of diabetic ketoacidosis, including severe thirst, nausea, vomiting, deep respirations, and stupor. Despite the absence of diabetes-related autoantibodies, the patient had extremely low levels of insulin and C-peptide release. Other potential causes of diabetes were ruled out, confirming the condition as serplulimab-induced immune checkpoint inhibitor-induced type 1 diabetes mellitus. After aggressive treatment to correct diabetic ketoacidosis, the patient\'s blood glucose levels stabilized and symptoms of diabetes improved significantly, although long-term insulin maintenance therapy was necessary.
CONCLUSIONS: This case highlights a rare, late-onset adverse event of immune checkpoint inhibitor-induced type 1 diabetes mellitus that may be overlooked during treatment with serplulimab. The monitoring of blood glucose levels and early signs and symptoms of diabetes cannot be relaxed at the late stage of treatment, even if patients do not have elevated blood glucose levels before and during the middle stage of treatment.
METHODS: This case report describes a 55-year-old male of Han nationality from China diagnosed with small-cell lung cancer with multiple metastases who experienced an adverse event of type 1 diabetes mellitus 68 weeks after receiving serplulimab therapy. The patient presented with typical symptoms of diabetic ketoacidosis, including severe thirst, nausea, vomiting, deep respirations, and stupor. Despite the absence of diabetes-related autoantibodies, the patient had extremely low levels of insulin and C-peptide release. Other potential causes of diabetes were ruled out, confirming the condition as serplulimab-induced immune checkpoint inhibitor-induced type 1 diabetes mellitus. After aggressive treatment to correct diabetic ketoacidosis, the patient\'s blood glucose levels stabilized and symptoms of diabetes improved significantly, although long-term insulin maintenance therapy was necessary.
CONCLUSIONS: This case highlights a rare, late-onset adverse event of immune checkpoint inhibitor-induced type 1 diabetes mellitus that may be overlooked during treatment with serplulimab. The monitoring of blood glucose levels and early signs and symptoms of diabetes cannot be relaxed at the late stage of treatment, even if patients do not have elevated blood glucose levels before and during the middle stage of treatment.
摘要：
背景：作为中国新批准的免疫检查点抑制剂，serplulimab已广泛用于肿瘤的免疫治疗。然而,免疫检查点抑制剂的免疫相关不良事件不容忽视.尽管免疫检查点抑制剂诱导的1型糖尿病是一种罕见的并发症，它可能导致糖尿病酮症酸中毒，危及患者的生命。
方法：本病例报告描述了一名55岁的中国汉族男性，在接受serplulimab治疗68周后，诊断为小细胞肺癌伴多发转移，出现1型糖尿病不良事件。患者出现典型的糖尿病酮症酸中毒症状，包括严重的口渴,恶心,呕吐,深呼吸,和愚蠢。尽管没有糖尿病相关的自身抗体，患者的胰岛素和C肽释放水平极低.排除了糖尿病的其他潜在原因，确认病情为serplulimab诱导的免疫检查点抑制剂诱导的1型糖尿病。在积极治疗以纠正糖尿病酮症酸中毒后，患者的血糖水平稳定，糖尿病症状明显改善，虽然长期胰岛素维持治疗是必要的。
结论：这个案例突出了一种罕见的，免疫检查点抑制剂诱导的1型糖尿病的迟发性不良事件在使用serplulimab治疗期间可能被忽视.治疗后期不能放松对血糖水平和糖尿病早期体征和症状的监测,即使患者在治疗前和治疗中期期间血糖水平没有升高。
方法：本病例报告描述了一名55岁的中国汉族男性，在接受serplulimab治疗68周后，诊断为小细胞肺癌伴多发转移，出现1型糖尿病不良事件。患者出现典型的糖尿病酮症酸中毒症状，包括严重的口渴,恶心,呕吐,深呼吸,和愚蠢。尽管没有糖尿病相关的自身抗体，患者的胰岛素和C肽释放水平极低.排除了糖尿病的其他潜在原因，确认病情为serplulimab诱导的免疫检查点抑制剂诱导的1型糖尿病。在积极治疗以纠正糖尿病酮症酸中毒后，患者的血糖水平稳定，糖尿病症状明显改善，虽然长期胰岛素维持治疗是必要的。
结论：这个案例突出了一种罕见的，免疫检查点抑制剂诱导的1型糖尿病的迟发性不良事件在使用serplulimab治疗期间可能被忽视.治疗后期不能放松对血糖水平和糖尿病早期体征和症状的监测,即使患者在治疗前和治疗中期期间血糖水平没有升高。
