Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy
To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM). Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as...
Gespeichert in:
| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2024-04, Vol.109 (5), p.1301-1307 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1307 |
|---|---|
| container_issue | 5 |
| container_start_page | 1301 |
| container_title | The journal of clinical endocrinology and metabolism |
| container_volume | 109 |
| creator | Wu, Linda Carlino, Matteo Salvatore Brown, David Alexander Long, Georgina Venetia Clifton-Bligh, Roderick Mellor, Rhiannon Moore, Krystal Sasson, Sarah Christina Menzies, Alexander Maxwell Tsang, Venessa Gunton, Jenny Elizabeth |
| description | To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM).
Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as defined by (1) previous immune checkpoint inhibitor (ICI) therapy, (2) new-onset hyperglycemia (blood glucose level ≥ 11.1 mmol/L and/or glycosylated hemoglobin ≥ 6.5%), and (3) insulin deficiency [C-peptide |
| doi_str_mv | 10.1210/clinem/dgad685 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2893834716</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2893834716</sourcerecordid><originalsourceid>FETCH-LOGICAL-c290t-38ee18e10e1ca46010734f2ef7f8c741d98f6dbf839e3300d2db15b3373824f03</originalsourceid><addsrcrecordid>eNo9kDtPwzAUhS0EoqWwMiKPLCl2nMT2WIVXpSIYQGKLHPuGGPLCdpDKryeoheku3z0650PonJIljSm50o3toL0yb8pkIj1AcyqTNOJU8kM0JySmkeTx6wydeP9OCE2SlB2jGeNScibIHH3lNeiPobddwOuutqUNvYtW3vfaqgAGr8bQ27YdO8DXVpUQwOMHaBobRo_XHue1ckoHcPZ7osstzqMBhmAN4E3vPVadwU-q0w5UsBqvguuHenuKjirVeDjb3wV6ub15zu-jzePdOl9tIh1LEiImAKgASoBqlWSEEs6SKoaKV0LzhBopqsyUlWASGCPExKakacnYNC5OKsIW6HKXO7j-cwQfitZ6PdVXHfSjL2IhmWAJp9mELneodlNvB1UxONsqty0oKX5dFzvXxd719HCxzx7LFsw__ieX_QBaVH4n</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2893834716</pqid></control><display><type>article</type><title>Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy</title><source>MEDLINE</source><source>Oxford Journals</source><creator>Wu, Linda ; Carlino, Matteo Salvatore ; Brown, David Alexander ; Long, Georgina Venetia ; Clifton-Bligh, Roderick ; Mellor, Rhiannon ; Moore, Krystal ; Sasson, Sarah Christina ; Menzies, Alexander Maxwell ; Tsang, Venessa ; Gunton, Jenny Elizabeth</creator><creatorcontrib>Wu, Linda ; Carlino, Matteo Salvatore ; Brown, David Alexander ; Long, Georgina Venetia ; Clifton-Bligh, Roderick ; Mellor, Rhiannon ; Moore, Krystal ; Sasson, Sarah Christina ; Menzies, Alexander Maxwell ; Tsang, Venessa ; Gunton, Jenny Elizabeth</creatorcontrib><description>To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM).
Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as defined by (1) previous immune checkpoint inhibitor (ICI) therapy, (2) new-onset hyperglycemia (blood glucose level ≥ 11.1 mmol/L and/or glycosylated hemoglobin ≥ 6.5%), and (3) insulin deficiency [C-peptide <0.4 nmol/L or diabetic ketoacidosis (DKA)] within 1 month of presentation. Pancreatic volume was available and measured using computed tomography volumetry for 17 patients with CIADM and 3 sets of control patients: 7 with ICI-related pancreatitis, 13 with asymptomatic ICI-related lipase elevation, and 11 ICI-treated controls for comparison.
All patients had either anti-programmed cell death protein 1 or anti-programmed cell death ligand 1 therapy. Median time from ICI commencement to CIADM diagnosis was 15 weeks. At presentation, 25 (69%) had DKA, 27 (84%) had low C-peptide, and, by 1 month, 100% had low C-peptide. Traditional type 1 diabetes autoantibodies were positive in 15/35 (43%). Lipase was elevated in 13/27 (48%) at presentation. In 4 patients with longitudinal lipase testing, elevated levels peaked 1 month prior to CIADM diagnosis. Pancreatic volume was lower pre-ICI in CIADM patients compared with controls and demonstrated a mean decline of 41% from pretreatment to 6 months post-CIADM diagnosis.
Pronounced biochemical and radiologic changes occur during CIADM pathogenesis. Rapid loss of C-peptide is a distinct characteristic that can be used to aid diagnosis as autoantibodies are often negative.</description><identifier>ISSN: 0021-972X</identifier><identifier>ISSN: 1945-7197</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/clinem/dgad685</identifier><identifier>PMID: 37997380</identifier><language>eng</language><publisher>United States</publisher><subject>Atrophy - chemically induced ; Autoantibodies ; C-Peptide ; Diabetes Mellitus, Type 1 - chemically induced ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetic Ketoacidosis ; Humans ; Lipase</subject><ispartof>The journal of clinical endocrinology and metabolism, 2024-04, Vol.109 (5), p.1301-1307</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c290t-38ee18e10e1ca46010734f2ef7f8c741d98f6dbf839e3300d2db15b3373824f03</cites><orcidid>0000-0002-8699-6341</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37997380$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Linda</creatorcontrib><creatorcontrib>Carlino, Matteo Salvatore</creatorcontrib><creatorcontrib>Brown, David Alexander</creatorcontrib><creatorcontrib>Long, Georgina Venetia</creatorcontrib><creatorcontrib>Clifton-Bligh, Roderick</creatorcontrib><creatorcontrib>Mellor, Rhiannon</creatorcontrib><creatorcontrib>Moore, Krystal</creatorcontrib><creatorcontrib>Sasson, Sarah Christina</creatorcontrib><creatorcontrib>Menzies, Alexander Maxwell</creatorcontrib><creatorcontrib>Tsang, Venessa</creatorcontrib><creatorcontrib>Gunton, Jenny Elizabeth</creatorcontrib><title>Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM).
Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as defined by (1) previous immune checkpoint inhibitor (ICI) therapy, (2) new-onset hyperglycemia (blood glucose level ≥ 11.1 mmol/L and/or glycosylated hemoglobin ≥ 6.5%), and (3) insulin deficiency [C-peptide <0.4 nmol/L or diabetic ketoacidosis (DKA)] within 1 month of presentation. Pancreatic volume was available and measured using computed tomography volumetry for 17 patients with CIADM and 3 sets of control patients: 7 with ICI-related pancreatitis, 13 with asymptomatic ICI-related lipase elevation, and 11 ICI-treated controls for comparison.
All patients had either anti-programmed cell death protein 1 or anti-programmed cell death ligand 1 therapy. Median time from ICI commencement to CIADM diagnosis was 15 weeks. At presentation, 25 (69%) had DKA, 27 (84%) had low C-peptide, and, by 1 month, 100% had low C-peptide. Traditional type 1 diabetes autoantibodies were positive in 15/35 (43%). Lipase was elevated in 13/27 (48%) at presentation. In 4 patients with longitudinal lipase testing, elevated levels peaked 1 month prior to CIADM diagnosis. Pancreatic volume was lower pre-ICI in CIADM patients compared with controls and demonstrated a mean decline of 41% from pretreatment to 6 months post-CIADM diagnosis.
Pronounced biochemical and radiologic changes occur during CIADM pathogenesis. Rapid loss of C-peptide is a distinct characteristic that can be used to aid diagnosis as autoantibodies are often negative.</description><subject>Atrophy - chemically induced</subject><subject>Autoantibodies</subject><subject>C-Peptide</subject><subject>Diabetes Mellitus, Type 1 - chemically induced</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetic Ketoacidosis</subject><subject>Humans</subject><subject>Lipase</subject><issn>0021-972X</issn><issn>1945-7197</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kDtPwzAUhS0EoqWwMiKPLCl2nMT2WIVXpSIYQGKLHPuGGPLCdpDKryeoheku3z0650PonJIljSm50o3toL0yb8pkIj1AcyqTNOJU8kM0JySmkeTx6wydeP9OCE2SlB2jGeNScibIHH3lNeiPobddwOuutqUNvYtW3vfaqgAGr8bQ27YdO8DXVpUQwOMHaBobRo_XHue1ckoHcPZ7osstzqMBhmAN4E3vPVadwU-q0w5UsBqvguuHenuKjirVeDjb3wV6ub15zu-jzePdOl9tIh1LEiImAKgASoBqlWSEEs6SKoaKV0LzhBopqsyUlWASGCPExKakacnYNC5OKsIW6HKXO7j-cwQfitZ6PdVXHfSjL2IhmWAJp9mELneodlNvB1UxONsqty0oKX5dFzvXxd719HCxzx7LFsw__ieX_QBaVH4n</recordid><startdate>20240419</startdate><enddate>20240419</enddate><creator>Wu, Linda</creator><creator>Carlino, Matteo Salvatore</creator><creator>Brown, David Alexander</creator><creator>Long, Georgina Venetia</creator><creator>Clifton-Bligh, Roderick</creator><creator>Mellor, Rhiannon</creator><creator>Moore, Krystal</creator><creator>Sasson, Sarah Christina</creator><creator>Menzies, Alexander Maxwell</creator><creator>Tsang, Venessa</creator><creator>Gunton, Jenny Elizabeth</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8699-6341</orcidid></search><sort><creationdate>20240419</creationdate><title>Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy</title><author>Wu, Linda ; Carlino, Matteo Salvatore ; Brown, David Alexander ; Long, Georgina Venetia ; Clifton-Bligh, Roderick ; Mellor, Rhiannon ; Moore, Krystal ; Sasson, Sarah Christina ; Menzies, Alexander Maxwell ; Tsang, Venessa ; Gunton, Jenny Elizabeth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c290t-38ee18e10e1ca46010734f2ef7f8c741d98f6dbf839e3300d2db15b3373824f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Atrophy - chemically induced</topic><topic>Autoantibodies</topic><topic>C-Peptide</topic><topic>Diabetes Mellitus, Type 1 - chemically induced</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetic Ketoacidosis</topic><topic>Humans</topic><topic>Lipase</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Linda</creatorcontrib><creatorcontrib>Carlino, Matteo Salvatore</creatorcontrib><creatorcontrib>Brown, David Alexander</creatorcontrib><creatorcontrib>Long, Georgina Venetia</creatorcontrib><creatorcontrib>Clifton-Bligh, Roderick</creatorcontrib><creatorcontrib>Mellor, Rhiannon</creatorcontrib><creatorcontrib>Moore, Krystal</creatorcontrib><creatorcontrib>Sasson, Sarah Christina</creatorcontrib><creatorcontrib>Menzies, Alexander Maxwell</creatorcontrib><creatorcontrib>Tsang, Venessa</creatorcontrib><creatorcontrib>Gunton, Jenny Elizabeth</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Linda</au><au>Carlino, Matteo Salvatore</au><au>Brown, David Alexander</au><au>Long, Georgina Venetia</au><au>Clifton-Bligh, Roderick</au><au>Mellor, Rhiannon</au><au>Moore, Krystal</au><au>Sasson, Sarah Christina</au><au>Menzies, Alexander Maxwell</au><au>Tsang, Venessa</au><au>Gunton, Jenny Elizabeth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2024-04-19</date><risdate>2024</risdate><volume>109</volume><issue>5</issue><spage>1301</spage><epage>1307</epage><pages>1301-1307</pages><issn>0021-972X</issn><issn>1945-7197</issn><eissn>1945-7197</eissn><abstract>To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM).
Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as defined by (1) previous immune checkpoint inhibitor (ICI) therapy, (2) new-onset hyperglycemia (blood glucose level ≥ 11.1 mmol/L and/or glycosylated hemoglobin ≥ 6.5%), and (3) insulin deficiency [C-peptide <0.4 nmol/L or diabetic ketoacidosis (DKA)] within 1 month of presentation. Pancreatic volume was available and measured using computed tomography volumetry for 17 patients with CIADM and 3 sets of control patients: 7 with ICI-related pancreatitis, 13 with asymptomatic ICI-related lipase elevation, and 11 ICI-treated controls for comparison.
All patients had either anti-programmed cell death protein 1 or anti-programmed cell death ligand 1 therapy. Median time from ICI commencement to CIADM diagnosis was 15 weeks. At presentation, 25 (69%) had DKA, 27 (84%) had low C-peptide, and, by 1 month, 100% had low C-peptide. Traditional type 1 diabetes autoantibodies were positive in 15/35 (43%). Lipase was elevated in 13/27 (48%) at presentation. In 4 patients with longitudinal lipase testing, elevated levels peaked 1 month prior to CIADM diagnosis. Pancreatic volume was lower pre-ICI in CIADM patients compared with controls and demonstrated a mean decline of 41% from pretreatment to 6 months post-CIADM diagnosis.
Pronounced biochemical and radiologic changes occur during CIADM pathogenesis. Rapid loss of C-peptide is a distinct characteristic that can be used to aid diagnosis as autoantibodies are often negative.</abstract><cop>United States</cop><pmid>37997380</pmid><doi>10.1210/clinem/dgad685</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8699-6341</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2024-04, Vol.109 (5), p.1301-1307 |
| issn | 0021-972X 1945-7197 1945-7197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2893834716 |
| source | MEDLINE; Oxford Journals |
| subjects | Atrophy - chemically induced Autoantibodies C-Peptide Diabetes Mellitus, Type 1 - chemically induced Diabetes Mellitus, Type 1 - drug therapy Diabetic Ketoacidosis Humans Lipase |
| title | Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T16%3A37%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Checkpoint%20Inhibitor-Associated%20Autoimmune%20Diabetes%20Mellitus%20Is%20Characterized%20by%20C-peptide%20Loss%20and%20Pancreatic%20Atrophy&rft.jtitle=The%20journal%20of%20clinical%20endocrinology%20and%20metabolism&rft.au=Wu,%20Linda&rft.date=2024-04-19&rft.volume=109&rft.issue=5&rft.spage=1301&rft.epage=1307&rft.pages=1301-1307&rft.issn=0021-972X&rft.eissn=1945-7197&rft_id=info:doi/10.1210/clinem/dgad685&rft_dat=%3Cproquest_cross%3E2893834716%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2893834716&rft_id=info:pmid/37997380&rfr_iscdi=true |