抗PD-1治疗晚期肝恶性肿瘤诱发1型糖尿病1例

Anti-PD-1 therapy in advanced malignant liver tumor-induced type-1 diabetes mellitus:a case report

免疫检查点抑制剂(ICI)的出现是肿瘤免疫治疗的重大突破,但其独特的作用机制也带来了许多免疫相关不良反应(irAE)。1型糖尿病(T1DM)是极为罕见的irAE之一,通过报道一例晚期肝恶性肿瘤患者在接受二线抗PD-1治疗后出现以血糖升高及高渗昏迷为初发症状的T1DM病例,并搜集回顾国内外相关文献,总结抗PD-1治疗诱发的T1DM的临床特征,以期达到早发现、早诊断、早治疗。

Immune checkpoint inhibitor(ICI)has been emerged as a major breakthrough in tumor immunotherapy,but its unique mechanism of action has also led to a number of immune-related adverse events(irAE).Type 1 diabetes mellitus(T1DM)is one of the rarest irAEs.This paper reports a case of advanced malignant liver tumor-induced T1DM who received second-line anti-PD-1 therapy and showed initial symptoms of hyperosmolar coma and hyperglycemia.In addition,the relevant literature at home and abroad was collected and reviewed,and the clinical characteristics of T1DM induced by anti-PD-1 therapy were summarized with a view to achieve early detection,diagnosis and treatment.