Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection
<b>Background and Clinical Significance</b>: Lung cancer, a leading cause of global cancer diagnoses, maintains the highest mortality risk despite advances in treatment. Immunotherapy agents, such as anti-programmed death-1/programmed death ligand-1 (PD-1/PD-L1), have revolutionized care...
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MDPI AG
2025-03-01
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| author | Raluca-Ileana Pătru Miruna Ghigeanu Maria-Alexandra Barbu Andreea Iuliana Ionescu Antone-Iordache Ionuț-Lucian |
| author_facet | Raluca-Ileana Pătru Miruna Ghigeanu Maria-Alexandra Barbu Andreea Iuliana Ionescu Antone-Iordache Ionuț-Lucian |
| author_sort | Raluca-Ileana Pătru |
| collection | DOAJ |
| description | <b>Background and Clinical Significance</b>: Lung cancer, a leading cause of global cancer diagnoses, maintains the highest mortality risk despite advances in treatment. Immunotherapy agents, such as anti-programmed death-1/programmed death ligand-1 (PD-1/PD-L1), have revolutionized care for non-small cell lung cancer (NSCLC). However, the success is tempered by the emergence of immune-mediated adverse reactions, including the rare onset of type I diabetes. The incidence of diabetes mellitus increased during the SARS-CoV-2 pandemic. While there are several cases of new-onset diabetes after COVID-19 and COVID-19 vaccination, no case of new-onset type 1 diabetes after COVID-19 was described in an immune checkpoint inhibitor (ICI)-treated patient. <b>Case Presentation</b>: A 57-year-old male with stage IV NSCLC (brain and liver metastases) who had been treated with nivolumab for 4 years appeared positive for SARS-CoV-2 infection at a routine check. After two weeks, he was admitted to our clinic with severe fatigue, hyperglycemia, hyponatremia, and hyperkalemia. HbA1c level was normal and serum peptide C was undetectable. Nivolumab treatment was ceased, and the patient became fully dependent on basal–bolus insulin. After 3 months, the patient showed a complete imagistic remission. <b>Conclusions</b>: The case presented significant challenges due to the unclear etiology of newly onset diabetes and the uncommon age at which type 1 diabetes is developed. The outcome suggests that anti-PD-1 and SARS-CoV-2 infection can act synergistically. |
| format | Article |
| id | doaj-art-a37903d695fa4189bc46d7bd70d01898 |
| institution | DOAJ |
| issn | 2571-841X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Reports |
| spelling | doaj-art-a37903d695fa4189bc46d7bd70d018982025-08-20T02:43:06ZengMDPI AGReports2571-841X2025-03-01813110.3390/reports8010031Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 InfectionRaluca-Ileana Pătru0Miruna Ghigeanu1Maria-Alexandra Barbu2Andreea Iuliana Ionescu3Antone-Iordache Ionuț-Lucian4Department of Medical Oncology, Colțea Clinical Hospital, 030167 Bucharest, RomaniaDepartment of Medical Oncology, Colțea Clinical Hospital, 030167 Bucharest, RomaniaDepartment of Oncology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Medical Oncology, Colțea Clinical Hospital, 030167 Bucharest, RomaniaDepartment of Oncological Radiotherapy and Medical Imaging, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania<b>Background and Clinical Significance</b>: Lung cancer, a leading cause of global cancer diagnoses, maintains the highest mortality risk despite advances in treatment. Immunotherapy agents, such as anti-programmed death-1/programmed death ligand-1 (PD-1/PD-L1), have revolutionized care for non-small cell lung cancer (NSCLC). However, the success is tempered by the emergence of immune-mediated adverse reactions, including the rare onset of type I diabetes. The incidence of diabetes mellitus increased during the SARS-CoV-2 pandemic. While there are several cases of new-onset diabetes after COVID-19 and COVID-19 vaccination, no case of new-onset type 1 diabetes after COVID-19 was described in an immune checkpoint inhibitor (ICI)-treated patient. <b>Case Presentation</b>: A 57-year-old male with stage IV NSCLC (brain and liver metastases) who had been treated with nivolumab for 4 years appeared positive for SARS-CoV-2 infection at a routine check. After two weeks, he was admitted to our clinic with severe fatigue, hyperglycemia, hyponatremia, and hyperkalemia. HbA1c level was normal and serum peptide C was undetectable. Nivolumab treatment was ceased, and the patient became fully dependent on basal–bolus insulin. After 3 months, the patient showed a complete imagistic remission. <b>Conclusions</b>: The case presented significant challenges due to the unclear etiology of newly onset diabetes and the uncommon age at which type 1 diabetes is developed. The outcome suggests that anti-PD-1 and SARS-CoV-2 infection can act synergistically.https://www.mdpi.com/2571-841X/8/1/31lung cancerimmunotherapytype I diabetesadverse effectSARS-CoV-2 pandemic |
| spellingShingle | Raluca-Ileana Pătru Miruna Ghigeanu Maria-Alexandra Barbu Andreea Iuliana Ionescu Antone-Iordache Ionuț-Lucian Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection Reports lung cancer immunotherapy type I diabetes adverse effect SARS-CoV-2 pandemic |
| title | Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection |
| title_full | Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection |
| title_fullStr | Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection |
| title_full_unstemmed | Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection |
| title_short | Type I Diabetes—A Rare Adverse Event Described in Patients Receiving Immunotherapy Versus a Side Effect from SARS-CoV-2 Infection |
| title_sort | type i diabetes a rare adverse event described in patients receiving immunotherapy versus a side effect from sars cov 2 infection |
| topic | lung cancer immunotherapy type I diabetes adverse effect SARS-CoV-2 pandemic |
| url | https://www.mdpi.com/2571-841X/8/1/31 |
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