{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T21:12:35Z","timestamp":1773177155576,"version":"3.50.1"},"reference-count":31,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,3]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Nivolumab is a programmed cell death receptor (PD-1) inhibitor that is increasingly used for various malignancies, both as a first line agent and as salvage therapy. Being a PD-1\/PD-1 ligand checkpoint inhibitor, it is known to cause autoimmune inflammation of various organs and has been associated with thyroiditis, insulitis, colitis, hepatitis and encephalitis to name a few. There are increasing reports of nivolumab leading to acute onset fulminant type 1 diabetes and diabetic ketoacidosis (DKA). We present a case of a 68-year-old man who developed DKA after 2 doses of nivolumab for metastatic melanoma. He was found to have type 1 diabetes, but no diabetes related antibodies were positive. He recovered from diabetes and continues to use insulin 1\u2009year after his diagnosis. This case and associated review illustrates the importance of educating and monitoring patients who start nivolumab therapy regarding this potentially life threatening complication.<\/jats:p>","DOI":"10.1136\/bcr-2019-229568","type":"journal-article","created":{"date-parts":[[2019,8,26]],"date-time":"2019-08-26T13:54:09Z","timestamp":1566827649000},"page":"e229568","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Rapid onset type-1 diabetes and diabetic ketoacidosis secondary to nivolumab immunotherapy: a review of existing literature"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8261-6997","authenticated-orcid":false,"given":"Hafez Mohammad Ammar","family":"Abdullah","sequence":"first","affiliation":[{"name":"Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radowan","family":"Elnair","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uzma Ikhtiar","family":"Khan","sequence":"additional","affiliation":[{"name":"Internal Medicine, Khyber Teaching Hospital, Peshawar, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Omar","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar L","family":"Morey-Vargas","sequence":"additional","affiliation":[{"name":"Endocrinology, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,26]]},"reference":[{"key":"2025082708305131000_12.8.e229568.1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s40425-017-0245-2","article-title":"Nivolumab-induced autoimmune diabetes mellitus presenting as diabetic ketoacidosis in a patient with metastatic lung cancer","volume":"5","author":"Godwin","year":"2017","journal-title":"J Immunother Cancer"},{"issue":"15_suppl","key":"2025082708305131000_12.8.e229568.2","doi-asserted-by":"crossref","first-page":"e22082","DOI":"10.1200\/JCO.2018.36.15_suppl.e22082","article-title":"Characterization of the onset of thyroid function (TF) abnormalities in patients receiving immune checkpoint inhibitor (CPI) therapy","volume":"36","author":"Elnair","year":"2018","journal-title":"Journal of Clinical Oncology"},{"key":"2025082708305131000_12.8.e229568.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-017-2033-8"},{"key":"2025082708305131000_12.8.e229568.4","doi-asserted-by":"publisher","DOI":"10.1172\/JCI80011"},{"key":"2025082708305131000_12.8.e229568.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2016.02.001"},{"key":"2025082708305131000_12.8.e229568.6","unstructured":"Food and Drug Administration. 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