{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:28:41Z","timestamp":1753892921953,"version":"3.41.2"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Immune checkpoint inhibitors, widely used in the treatment of malignancies, can improve the prognosis of patients, while it also can induce various immune-related adverse events, and type 1 diabetes induced by anti-programmed cell death protein-1 is a rare but severe complication. Here we reported a case of type 1 diabetes induced by anti-PD-1 which was to treat intrahepatic cholangiocarcinoma. The case was a 61-year-old female who developed diabetes and ketoacidosis symptoms at the 16th week after anti-PD-1 therapy. Her blood glucose was 30.32 mmol\/L, HBA1c was 8.10%, and C-peptide was &amp;lt;0.10 ng\/ml. The patient was diagnosed as fulminant type 1 diabetes mellitus complicated with ketoacidosis induced by anti-PD-1, and was treated with massive fluid rehydration, intravenous infusion of insulin and correction of acid-base electrolyte disorder. Hepatectomy was performed after stabilization, and the patient was treated with long-term insulin. Through the case report and literature review, this study aims to improve oncologists' understanding of anti-PD-1 induced type 1 diabetes, so as to make early diagnosis and treatment of the complications and ensure medical safety.<\/jats:p>","DOI":"10.3389\/fpubh.2022.917679","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T07:03:01Z","timestamp":1655362981000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Anti-programmed Cell Death Protein-1 Therapy in Intrahepatic Cholangiocarcinoma Induced Type 1 Diabetes: A Case Report and Literature Review"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhi-Kai","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiong-Liang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Xuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian-Qing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Shan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhong-Guo","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3144","DOI":"10.1210\/jc.2018-00728","article-title":"Programmed cell death-1 inhibitor-induced type 1 diabetes mellitus","volume":"103","author":"Clotman","year":"2018","journal-title":"J Clin Endocrinol Metab."},{"key":"B2","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/CJI.0000000000000218","article-title":"Diabetes and blood glucose disorders under anti-PD1","volume":"41","author":"Magis","year":"2018","journal-title":"J Immunother."},{"key":"B3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1055\/a-0843-3366","article-title":"A systematic review and meta-analysis of endocrine-related adverse events associated with immune checkpoint inhibitors","volume":"51","author":"De Filette","year":"2019","journal-title":"Hormone Metab Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1530\/EJE-19-0291","article-title":"Immune checkpoint inhibitors and type 1 diabetes mellitus: a case report and systematic review","volume":"181","author":"De Filette","year":"2019","journal-title":"Eur J Endocrinol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1136\/bcr-2019-229568","article-title":"Rapid onset type-1 diabetes and diabetic ketoacidosis secondary to nivolumab immunotherapy: a review of existing literature","volume":"12","author":"Abdullah","year":"2019","journal-title":"BMJ Case Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1172\/JCI131194","article-title":"Time to dissect the autoimmune etiology of cancer antibody immunotherapy","volume":"130","author":"Dougan","year":"2020","journal-title":"J Clin Invest."},{"key":"B7","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1097\/MD.0000000000017832","article-title":"Significant response to anti-PD-1 based immunotherapy plus lenvatinib for recurrent intrahepatic cholangiocarcinoma with bone metastasis: a case report and literature review","volume":"98","author":"Chen","year":"2019","journal-title":"Medicine."},{"key":"B8","doi-asserted-by":"publisher","first-page":"368","DOI":"10.3389\/fmed.2020.00368","article-title":"Anti-PD-1 immunotherapy and radiotherapy for stage iv intrahepatic cholangiocarcinoma: a case report","volume":"7","author":"Long","year":"2020","journal-title":"Front Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1530\/ERC-17-0358","article-title":"Endocrine side effects of cancer immunotherapy","volume":"24","author":"Cukier","year":"2017","journal-title":"Endocr Relat Cancer."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40842-018-0073-4","article-title":"Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports","volume":"5","author":"Tan","year":"2019","journal-title":"Clin Diabetes Endocrinol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"100011","DOI":"10.1016\/j.esmoop.2020.100011","article-title":"How we treat endocrine complications of immune checkpoint inhibitors","volume":"6","author":"Paschou","year":"2021","journal-title":"ESMO Open."},{"key":"B12","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1001\/jamaoncol.2017.3064","article-title":"Incidence of endocrine dysfunction following the use of different immune checkpoint inhibitor regimens: a systematic review and meta-analysis","volume":"4","author":"Barroso-Sousa","year":"2018","journal-title":"JAMA Oncol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.2337\/dbi18-0002","article-title":"Collateral damage: insulin-dependent diabetes induced with checkpoint inhibitors","volume":"67","author":"Stamatouli","year":"2018","journal-title":"Diabetes."},{"key":"B14","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s00592-018-1234-8","article-title":"Diabetes mellitus induced by PD-1 and PD-L1 inhibitors: description of pancreatic endocrine and exocrine phenotype","volume":"56","author":"Marchand","year":"2019","journal-title":"Acta Diabetol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"101193","DOI":"10.1016\/j.diabet.2020.09.003","article-title":"Immune checkpoint inhibitors and diabetes: mechanisms and predictors","volume":"47","author":"Youssef","year":"2021","journal-title":"Diabetes Metab."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1111\/dme.14050","article-title":"Immune checkpoint inhibitor-induced Type 1 diabetes: a systematic review and meta-analysis","volume":"36","author":"Akturk","year":"2019","journal-title":"Diabetic Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1080\/00325481.2019.1709344","article-title":"Immune checkpoint inhibitors and endocrine side effects, a narrative review","volume":"132","author":"Agrawal","year":"2020","journal-title":"Postgrad Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1177\/0897190019850929","article-title":"Programmed cell death-1 monoclonal antibody therapy and type 1 diabetes mellitus: a review of the literature","volume":"34","author":"Farina","year":"2021","journal-title":"J Pharm Pract."},{"key":"B19","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.cellimm.2016.09.009","article-title":"PD-1\/PD-L and autoimmunity: a growing relationship","volume":"310","author":"Zamani","year":"2016","journal-title":"Cell Immunol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1210\/er.2018-00006","article-title":"Endocrine toxicity of cancer immunotherapy targeting immune checkpoints","volume":"40","author":"Chang","year":"2019","journal-title":"Endocr Rev."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1007\/s00262-017-2033-8","article-title":"Autoimmune diabetes induced by PD-1 inhibitor-retrospective analysis and pathogenesis: a case report and literature review","volume":"66","author":"Gauci","year":"2017","journal-title":"Cancer Immunol Immunother."},{"key":"B22","doi-asserted-by":"publisher","first-page":"379","DOI":"10.21037\/tlcr.2020.03.05","article-title":"Anti PD-1 monoclonal antibody induced autoimmune diabetes mellitus: a case report and brief review","volume":"9","author":"Li","year":"2020","journal-title":"Transl Lung Cancer Res."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2595","DOI":"10.1097\/CM9.0000000000000972","article-title":"Type 1 diabetes induced by immune checkpoint inhibitors","volume":"133","author":"Zhang","year":"2020","journal-title":"Chin Med J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"417","DOI":"10.7861\/clinmed.2020-0054","article-title":"Is immune checkpoint inhibitor-associated diabetes the same as fulminant type 1 diabetes mellitus?","volume":"20","author":"Kyriacou","year":"2020","journal-title":"Clin Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.2337\/db09-1135","article-title":"Deficiency in B7-H1 (PD-L1)\/PD-1 coinhibition triggers pancreatic beta-cell destruction by insulin-specific, murine CD8 T-cells","volume":"59","author":"Rajasalu","year":"2010","journal-title":"Diabetes J Am Diab Assoc."},{"key":"B26","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1038\/nrendo.2016.205","article-title":"Cancer immunotherapy-immune checkpoint blockade and associated endocrinopathies","volume":"13","author":"Byun","year":"2017","journal-title":"Nat Rev Endocrinol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"3106","DOI":"10.2337\/dc20-0609","article-title":"Immune checkpoint inhibitor-associated diabetes: a single-institution experience","volume":"43","author":"Byun","year":"2020","journal-title":"Diabetes Care."},{"key":"B28","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1038\/ncpendmet0351","article-title":"Fulminant type 1 diabetes: a novel clinical entity requiring special attention by all medical practitioners","volume":"3","author":"Toshiaki","year":"2007","journal-title":"Nat Clin Pract Endocrinol Metab."},{"key":"B29","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jtho.2016.12.015","article-title":"Association of serum anti-GAD antibody and HLA haplotypes with type 1 diabetes mellitus triggered by nivolumab in patients with non-small cell lung cancer","volume":"12","author":"Yuko","year":"2017","journal-title":"J Thorac Oncol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"djw260","DOI":"10.1093\/jnci\/djw260","article-title":"Thinking critically about classifying adverse events: incidence of pancreatitis in patients treated with nivolumab + ipilimumab","volume":"109","author":"Friedman","year":"2017","journal-title":"J Natl Cancer Inst."},{"key":"B31","first-page":"4683","article-title":"Altered glucose metabolism during chemoradiation for head and neck cancer","volume":"29","author":"Nguyen","year":"2009","journal-title":"Anticancer Res."},{"key":"B32","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1111\/j.1463-1318.2012.03097.x","article-title":"Secondary diabetes associated with 5-fluorouracil-based chemotherapy regimens in non-diabetic patients with colorectal cancer: results from a single-centre cohort study","volume":"15","author":"Feng","year":"2013","journal-title":"Colorectal Dis."},{"key":"B33","doi-asserted-by":"publisher","first-page":"241109","DOI":"10.1136\/bcr-2020-241109","article-title":"Capecitabine-induced hyperosmolar hyperglycaemic state","volume":"14","author":"Carly","year":"2021","journal-title":"BMJ Case Rep."},{"key":"B34","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1177\/1078155214532508","article-title":"Hypertriglyceridemia and hyperglycemia induced by capecitabine: a report of two cases and review of the literature","volume":"21","author":"Han","year":"2015","journal-title":"J Oncol Pharm Pract."},{"key":"B35","doi-asserted-by":"publisher","first-page":"704","DOI":"10.4103\/1119-3077.187323","article-title":"Variations of blood glucose in cancer patients during chemotherapy","volume":"19","author":"Yang","year":"2016","journal-title":"Niger J Clin Pract."},{"key":"B36","doi-asserted-by":"publisher","first-page":"bcr2016217454","DOI":"10.1136\/bcr-2016-217454","article-title":"Glucocorticoids did not reverse type 1 diabetes mellitus secondary to pembrolizumab in a patient with metastatic melanoma","volume":"2016","author":"Aleksova","year":"2016","journal-title":"BMJ Case Reports."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1001\/jamaoncol.2016.1051","article-title":"Treatment of the immune-related adverse effects of immune checkpoint inhibitors: a review","volume":"2","author":"Friedman","year":"2016","journal-title":"JAMA Oncol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.ejca.2016.02.025","article-title":"Cutaneous, gastrointestinal, hepatic, endocrine, and renal side-effects of anti-PD-1 therapy","volume":"60","author":"Hofmann","year":"2016","journal-title":"Eur J Cancer."},{"key":"B39","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1620\/tjem.239.155","article-title":"Nivolumab, an anti-programmed cell death-1 antibody, induces fulminant type 1 diabetes","volume":"239","author":"Miyoshi","year":"2016","journal-title":"Tohoku Univ Med Press."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1634\/theoncologist.2017-0133","article-title":"Immune-related adverse events as a biomarker in non-melanoma patients treated with programmed cell death 1 inhibitors","volume":"22","author":"Judd","year":"2017","journal-title":"Oncologist."},{"key":"B41","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1158\/1078-0432.CCR-15-1136","article-title":"Nivolumab in resected and unresectable metastatic melanoma: characteristics of immune-related adverse events and association with outcomes","volume":"22","author":"Morganna","year":"2016","journal-title":"Clin Cancer Res."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.917679\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T07:03:04Z","timestamp":1655362984000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.917679\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,16]]},"references-count":41,"alternative-id":["10.3389\/fpubh.2022.917679"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.917679","relation":{},"ISSN":["2296-2565"],"issn-type":[{"type":"electronic","value":"2296-2565"}],"subject":[],"published":{"date-parts":[[2022,6,16]]},"article-number":"917679"}}