PMID- 33786278
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210825
IS  - 2190-1678 (Print)
IS  - 2190-1686 (Electronic)
IS  - 2190-1678 (Linking)
VI  - 12
IP  - 2
DP  - 2021 Apr
TI  - Case of slowly progressive type 1 diabetes mellitus with drastically reduced 
      insulin secretory capacity after immune checkpoint inhibitor treatment for 
      advanced renal cell carcinoma.
PG  - 234-240
LID - 10.1007/s13340-020-00459-1 [doi]
AB  - We encountered a 55-year-old Japanese man with advanced renal cell carcinoma and 
      slowly progressive type 1 diabetes mellitus (SPT1DM), whose insulin secretory 
      capacity was drastically reduced for a brief period after only one cycle of 
      immune checkpoint inhibitor (ICI) treatment. The patient had been diagnosed with 
      type 2 diabetes at the age of 53 years and was treated using oral hypoglycemic 
      agents. However, 2 years later, he was diagnosed with SPT1DM and autoimmune 
      thyroiditis, based on the presence of anti-glutamic acid decarboxylase antibodies 
      (GADA) and thyroid autoantibodies, which was accompanied by advanced renal cell 
      carcinoma. At that time, his insulin secretory capacity was preserved (CPR 
      2.36 ng/mL), and good glycemic control was maintained using only medical 
      nutrition therapy (HbA1c 6.3%). He subsequently developed destructive thyroiditis 
      approximately 2 weeks after the first cycle of ICI treatment using nivolumab (a 
      programmed cell death-1 inhibitor) and ipilimumab (a cytotoxic 
      T-lymphocyte-associated antigen-4 inhibitor) for advanced renal cell carcinoma. 
      Three weeks later, his plasma glucose level markedly increased, and we detected 
      absolute insulin deficiency and hypothyroidism. Human leukocyte antigen (HLA) 
      analysis revealed haplotypes indicating susceptibility to type 1 diabetes 
      mellitus (T1DM) or autoimmune thyroiditis (HLA genotype, DRB1-DQB1 
      *09:01-*03:03/*08:03-*06:01). He showed a good antitumor response and is 
      currently receiving permanent insulin therapy and levothyroxine replacement with 
      the ICI treatment. Based on this case and the available literature, patients with 
      preexisting islet autoantibodies or SPT1DM/LADA, plus a genetic predisposition to 
      T1DM, may have an extremely high risk of developing ICI-related T1DM for a brief 
      period after starting ICI treatment.
CI  - (c) The Japan Diabetes Society 2020.
FAU - Yamaguchi, Hiroki
AU  - Yamaguchi H
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Miyoshi, Yumika
AU  - Miyoshi Y
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Uehara, Yuhei
AU  - Uehara Y
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Fujii, Kohei
AU  - Fujii K
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Nagata, Shimpei
AU  - Nagata S
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Obata, Yoshinari
AU  - Obata Y
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Kosugi, Motohiro
AU  - Kosugi M
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Hazama, Yoji
AU  - Hazama Y
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
FAU - Yasuda, Tetsuyuki
AU  - Yasuda T
AUID- ORCID: 0000-0002-1128-8834
AD  - Department of Diabetes and Endocrinology, Osaka Police Hospital, 10-31 
      Kitayama-cho Tennoujiku, Osaka, 543-0035 Japan. GRID: grid.416980.2. ISNI: 0000 
      0004 1774 8373
LA  - eng
PT  - Case Reports
DEP - 20200824
PL  - Japan
TA  - Diabetol Int
JT  - Diabetology international
JID - 101553224
PMC - PMC7943686
OTO - NOTNLM
OT  - Immune checkpoint inhibitors
OT  - Insulin secretion
OT  - Islet autoantibodies
OT  - Nivolumab
OT  - Renal cell carcinoma
OT  - Slowly progressive type 1 diabetes mellitus
COIS- Conflicts of interestTetsuyuki Yasuda has received lecture fees from Takeda 
      Pharmaceutical Company Limited, Novartis Pharmaceuticals Corp., and Nippon 
      Boehringer Ingelheim Co., Ltd. The other authors declare that they have no 
      conflicts of interest.
EDAT- 2021/04/01 06:00
MHDA- 2021/04/01 06:01
PMCR- 2021/08/24
CRDT- 2021/03/31 06:41
PHST- 2020/05/25 00:00 [received]
PHST- 2020/08/13 00:00 [accepted]
PHST- 2021/03/31 06:41 [entrez]
PHST- 2021/04/01 06:00 [pubmed]
PHST- 2021/04/01 06:01 [medline]
PHST- 2021/08/24 00:00 [pmc-release]
AID - 459 [pii]
AID - 10.1007/s13340-020-00459-1 [doi]
PST - epublish
SO  - Diabetol Int. 2020 Aug 24;12(2):234-240. doi: 10.1007/s13340-020-00459-1. 
      eCollection 2021 Apr.