NIVOLUMAB-INDUCED DIABETIC KETOACIDOSIS

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Nivolumab-induced fulminant diabetic ketoacidosis followed by thyroiditis

Five days following the 3rd cycle of nivolumab, a monoclonal antibody, which acts as immune checkpoint inhibitor against the programmed cell death protein-1, for metastatic lung adenocarcinoma, a 56-year-old woman presented at the hospital critically ill. On admission, she had severe diabetic ketoacidosis (DKA), as evidenced by venous glucose of 47 mmol/L, blood ketones of 7.5 mmol/L, pH of 6.9...

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Nivolumab-induced autoimmune diabetes mellitus presenting as diabetic ketoacidosis in a patient with metastatic lung cancer

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Diabetic ketoacidosis.

A diagnosis of diabetic ketoacidosis requires the patient's plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7.30, and the bicarbonate level to be 18 mEq per L or less. Beta-hydroxybutyrate is a better measurement of the degree of ketosis than serum ketones. Intravenous insulin and fluid replacement are the mainstays of th...

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Diabetic Ketoacidosis

A chronic autoimmune destruction of the pancreatic beta cells results in decreasing endoge‐ nous insulin secretion and the clinical manifestation of type 1 diabetes mellitus (T1DM). The clinical onset of the disease is often acute in children and adolescents and diabetic ketoaci‐ dosis (DKA) is present in 20-74% of the patients [1-7]. DKA is a serious condition that re‐ quiring immediate interv...

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ژورنال

عنوان ژورنال: Chest

سال: 2020

ISSN: 0012-3692

DOI: 10.1016/j.chest.2020.08.740