Nivolumab-induced autoimmune diabetes mellitus and hypothyroidism in a patient with rectal neuroendocrine tumor

• DOI: 10.1080/20009666.2020.1771126
• Publication Date: 2020-08-02T18:10:35Z
• Authors: Waqas Haque; Shabina R. Ahmed; Mihail Zilbermint
• Keywords: Diabetic ketoacidosis; Autoimmune diabetes

We present a rare case of autoimmune diabetes mellitus and hypothyroidism in an elderly man initiated on nivolumab two months prior to admission for treatment high-grade neuroendocrine rectal tumor. This patient presented local community hospital with one-week history severe nausea, thirst, bilateral leg edema. Biochemical studies confirmed the diagnosis diabetic ketoacidosis setting primary hypothyroidism, likely due use. illustrates acute complication secondary novel anticancer agent. There are three key takeaways physicians managing patients nivolumab. First, there should be discussion benefits risks immunomodulatory therapy. Second, tested immunological other markers before being started checkpoint inhibitors. Third, oncologists must aware signs symptoms life-threatening hyperglycemia hypothyroidism. Additional needed identify those at highest risk complications.