1例PD-1抑制剂相关暴发性1型糖尿病病例报道及文献复习

One case of fulminant type 1 diabetes mellitus caused by PD-1 inhibitor and literature review

1例46岁男性患者,因“高血糖11个月余,多饮多尿3个月”入院,既往右腮腺转移性鳞癌术后、放疗后。应用注射用卡瑞利珠单抗约4个月余后出现明显口干、多饮、多尿、泡沫尿、体重下降等症状,入院诊断为程序性死亡受体1(PD-1)抑制剂相关暴发性1型糖尿病,予以停药、胰岛素泵联合二甲双胍治疗,排除并发症、合并症和PD-1抑制剂相关的其他内分泌系统免疫相关不良事件,2周后患者病情稳定出院。

A 46-year-old male patient was admitted to the hospital due to hyperglycemia for more than 11 months,polydipsia and polyuria for 3 months.He had a history of postoperative and post-radiotherapy of metastatic squamous cell carcinoma of the right parotid gland and was treated with camrelizumab.About 4 months later,he developed obvious thirst,polydipsia,polyuria,foamy urine,weight loss,etc and was diagnosed with programmed death receptor‑1(PD-1)inhibitor related fulminant type 1 diabetes mellitus.The drug was stopped and he was treated with insulin pump combined with metformin.Complications and other endocrine immune-related adverse events related to PD-1 inhibitors were excluded,the patient was discharged in stable condition after 2 weeks.