信迪利单抗治疗胃癌致1型糖尿病1例

A case of type 1 diabetes caused by gastric cancer treated with Sintilimab

免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)目前应用于多种肿瘤的治疗中,在肿瘤治疗中扮演着重要角色,随之而来的也有许多与免疫系统相关的不良反应。1型糖尿病(type diabetes mellitus,T1DM)是比较罕见的内分泌系统并发症,目前报道较少。我们报道1例使用ICIs治疗胃癌后出现T1DM的病例。患者男,34岁,使用信迪利单抗206 d后出现糖尿病酮症酸中毒,空腹血糖15.78 mmol/L,糖化血红蛋白8.6%。胰岛相关抗体:谷氨酸脱羧酶抗体:119.2 kU/L;胰岛素抗体:<2 U/L。空腹胰岛素:0.21 mU/L;空腹C肽:0.12μg/L。通过对患者临床资料的分析,旨在提高临床医师对免疫相关性1型糖尿病的认识,同时为正确的诊治提供思路。

Immune checkpoint inhibitors(ICIs)are currently used in the treatment of various tumors and play an important role in tumor treatment,resulting in many adverse reactions related to the immune system.Type 1 diabetes(T1DM)is a rare endocrine system complication,which is rarely reported at present.We report a case of T1DM after using ICIs to treat gastric cancer.The patient was a 34 year old male who developed diabetes ketoacidosis after 206 days of sintilimab monoclonal antibody use,with fasting blood glucose of 15.78 mmol/L and glycosylated hemoglobin of 8.6%.Islet related antibody:Glutamate decarboxylase antibody:119.2 IU/mL;Insulin antibody:<2 IU/L.Fasting insulin:0.21 mU/L;Fasting C-peptide:0.12μg/L.Through the analysis of patients'clinical data,it aims to improve clinicians'understanding of immune related type 1 diabetes and provide ideas for correct diagnosis and treatment.