Open AccessCase of fulminant type 1 diabetes induced by the anti‐programmed death‐ligand 1 antibody, avelumab
Author(s) -
Shibayama Yui,
Kameda Hiraku,
Ota Shoichiro,
Tsuchida Kazuhisa,
Cho Kyu Yong,
Nakamura Akinobu,
Miyoshi Hideaki,
Atsumi Tatsuya
Publication year - 2019
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13022
Subject(s) - medicine , avelumab , fulminant , type 1 diabetes , antibody , diabetes mellitus , type 2 diabetes , immunology , endocrinology , nivolumab , immune system , immunotherapy
With the expansive use of immune checkpoint inhibitors, the frequency of immune‐related adverse events, including autoimmune type 1 diabetes, has been exponentially increased. The anti‐programmed death‐ligand 1 antibody, avelumab, has recently been approved for metastatic Merkel cell carcinoma therapy. Here, we report a patient that developed fulminant type 1 diabetes during avelumab treatment. An 81‐year‐old woman with no history of diabetes received avelumab for metastatic Merkel cell carcinoma. Elevated plasma glucose level (483 mg/dL), hemoglobin A1c level (7.5%) and ketosis were observed after 10 courses of avelumab without any symptoms related to hyperglycemia. As the laboratory tests showed insulin depletion, we diagnosed her with fulminant type 1 diabetes induced by avelumab. This is the first reported case of avelumab‐induced type 1 diabetes, illustrating the necessity for close monitoring of glycemic control during avelumab therapy, as well as other immune checkpoint inhibitors.