Fulminant type 1 diabetes associated with Isolated ACTH deficiency induced by anti-programmed cell death 1 antibody-insight into the pathogenesis of autoimmune endocrinopathy

Endocrine Journal
Sumie OkahataTeruo Shiba

Abstract

Therapeutic blocking antibodies against programmed death 1 (PD1) and cytotoxic T-lymphocyte antigen 4 (CTLA4) are applied for advanced cancer therapy, but induce a wide range of immune-related adverse events. In our recent case of a 52-year-old female doctor suffering from breast cancer having metastasized to the lung and liver, it was decided to use nivolumab to prevent the disease progressing after excisional surgeries and multiple chemotherapies. One month after completing the nivolumab course, fatigue, hypoglycemia and hypotension developed and isolated ACTH deficiency (IAD) was diagnosed. A further month later, under steroid supplementation, hyperglycemia emerged alongside thirst and polydipsia, prompting a diagnosis of fulminant type 1 diabetes (FT1D). Her susceptibility to type 1 diabetes was examined by HLA haplotype and CTLA4 gene polymorphism analyses. Polymorphisms CT60G>A and +49G>A in CTLA4 both generated a GG genotype. Our patient manifested one of the rarest combinations of autoimmune disease induced by nivolumab. Whereas the HLA haplotype was unsusceptible to autoimmune type 1 diabetes, polymorphisms of CTLA4, the antibody of which frequently causes hypophysitis, were susceptible to FT1D. Peripheral modulation o...Continue Reading

References

Jul 9, 2003·The Journal of Experimental Medicine·Mohammed Javeed I AnsariMohamed H Sayegh
Dec 23, 2004·The Journal of Clinical Endocrinology and Metabolism·Sophie Vallette-KasicJacques Drouin
Jan 7, 2005·Endocrine Reviews·Patrizio CaturegliNoel R Rose
Jan 20, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·N KaravitakiD Wade
Nov 2, 2006·Pituitary·Massimiliano AndrioliFrancesco Cavagnini
Jan 6, 2009·Hormones : International Journal of Endocrinology and Metabolism·Vassiliki SyriouMargarita Anapliotou
Jan 17, 2009·Diabetes Research and Clinical Practice·Scherezade MominFrancisco Perez-Bravo
Nov 16, 2010·Seminars in Oncology·Margaret K CallahanJames P Allison
Feb 18, 2014·Journal of Leukocyte Biology·Luis C Antón, Jonathan W Yewdell
Aug 1, 2014·The Journal of Clinical Endocrinology and Metabolism·Alexander T FajeLisa Nachtigall
Apr 21, 2016·Trends in Endocrinology and Metabolism : TEM·Maria J L KrachtBart O Roep
Jun 17, 2016·The Oncologist·Elisa González-RodríguezUNKNOWN Spanish Group for Cancer Immuno-Biotherapy (GETICA)
Jan 21, 2017·Nature Reviews. Endocrinology·David J ByunMonica Girotra
Sep 1, 2017·Melanoma Research·Aikaterini TsiogkaPeter Koelblinger
Jun 26, 2018·Diabetes·Angeliki M StamatouliKevan C Herold
Jul 5, 2016·Diabetology International·Hiroshi IkegamiShinsuke Noso

❮ Previous
Next ❯

Citations

Aug 26, 2020·Chinese Medical Journal·Rui ZhangLi-Nong Ji
Nov 18, 2020·Cancer Immunology, Immunotherapy : CII·Zhe ZhaoDan Zhang
Oct 23, 2020·Diabetology International·Akihisa Imagawa, Megumi Tachibana
Mar 25, 2021·Pituitary·Pedro IglesiasJuan José Díez
Jan 5, 2021·Expert Opinion on Biological Therapy·Maria V DeligiorgiDimitrios T Trafalis

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diseases

Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

Autoimmune Hepatitis

Autoimmune hepatitis formerly called lupoid hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells causing the liver to be inflamed. Discover the latest research on autoimmune hepatitis here.

Breast Invasive Carcinoma (Keystone)

Invasive breast cancers indicate a spread into breast tissues and lymph nodes. Here are the latest discoveries pertaining to breast invasive carcinomas.

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.

Breast Invasive Carcinoma

Invasive breast cancers indicate a spread into breast tissues and lymph nodes. Here are the latest discoveries pertaining to breast invasive carcinomas.

Breast Cancer: Therapeutic Approaches

Several different therapeutic approaches are used to treat breast cancer. These include chemotherapy, hormonal therapy, targeted therapy, and Immunotherapy. Discover the latest research on breast cancer therapeutic approaches here.

Related Papers

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Clemens SpinkSigrid Harendza
Journal of the Endocrine Society
Keitaro KanieYutaka Takahashi
© 2022 Meta ULC. All rights reserved