Simultaneous development of Graves’ disease and type 1 diabetes during anti‐programmed cell death‐1 therapy: A case report

• Published in: Journal of diabetes investigation Vol. 11; no. 4; pp. 1006 - 1009
• Main Authors: Kurihara, Susumu, Oikawa, Yoichi, Nakajima, Ritsuko, Satomura, Atsushi, Tanaka, Ryuhei, Kagamu, Hiroshi, Shimada, Akira
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01-07-2020; John Wiley and Sons Inc; Wiley
• Subjects: Adenocarcinoma; Adenocarcinoma - drug therapy; Adenocarcinoma - immunology; Antibodies; Antigens; Antineoplastic Agents, Immunological - adverse effects; Anti‐programmed death 1 therapy; Apoptosis; Case Report; Case reports; Cell death; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - chemically induced; Diabetes Mellitus, Type 1 - immunology; Disease; Drb1 protein; Glucose; Graves Disease - chemically induced; Graves Disease - immunology; Graves' disease; Hemoglobin; Histocompatibility antigen HLA; Humans; Hyperthyroidism; Hypothyroidism; Immunotherapy; Insulin; Male; Metastases; Metastasis; Middle Aged; Monoclonal antibodies; Nivolumab - adverse effects; Parotid gland; Parotid Neoplasms - drug therapy; Parotid Neoplasms - immunology; Patients; PD-1 protein; Peptides; Plasma; Programmed Cell Death 1 Receptor - antagonists & inhibitors; Thyroid; Thyroid gland; Thyrotoxicosis; Type 1 diabetes; Graves’ disease; Anti-programmed death 1 therapy; Type 1 diabetes
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13212

We present the first case of simultaneous development of Graves’ disease and type 1 diabetes during anti‐programmed cell death 1 therapy. A 48‐year‐old man with parotid gland adenocarcinoma and lung metastasis had received five courses of nivolumab. Fourteen days after administration of the sixth course, his casual plasma glucose and hemoglobin A1c levels were 379 mg/dL and 7.2%, respectively. Furthermore, thyrotoxicosis was detected with a blood test. Serum total ketone body and thyroid‐stimulating hormone receptor antibody levels increased, and serum C‐peptide level decreased to 0.01 ng/mL thereafter. Thus, we concluded that he simultaneously developed anti‐programmed cell death 1 therapy‐associated type 1 diabetes and Graves’ disease. Among Japanese patients with autoimmune polyglandular syndrome type III, the frequency of human leukocyte antigen‐DRB1*04:05 is higher in those with both type 1 diabetes and Graves’ disease. Our case had human leukocyte antigen‐DRB1*04:05, which might be associated with the simultaneous development of the two diseases.
We present the first case of simultaneous development of Graves’ disease and type 1 diabetes during anti‐programmed cell death 1 therapy. Among Japanese participants with autoimmune polyglandular syndrome type III, the frequency of human leukocyte antigen‐DRB1*04:05 is higher in those with both type 1 diabetes and Graves’ disease. The present participant carried the human leukocyte antigen‐DRB1*04:05; which might be associated with the simultaneous development of the two diseases.