Abstract:
OBJECTIVE:Anti-programmed cell death-1 (anti-PD-1) antibodies have revolutionized advanced cancer therapy. Anti-PD-1 therapy is responsible for immune-related adverse events, with frequent endocrine manifestations, including acute-onset type 1 diabetes. Acquired generalized lipodystrophy (AGL) is a rare disease, believed to be immune mediated, characterized by loss of adipose tissue and insulin resistance-associated complications. RESEARCH DESIGN AND METHODS:We describe the first reported case of AGL induced by immune checkpoint therapy. RESULTS:A 62-year-old woman with metastatic melanoma treated with nivolumab was referred for major hyperglycemia, hypertriglyceridemia, and nonalcoholic steatohepatitis. She had presented with a rapidly progressive generalized loss of subcutaneous adipose tissue. Diabetes was associated with severe insulin resistance and undetectable plasma leptin. Subcutaneous biopsy revealed atrophic adipose tissue infiltrated with cytotoxic CD8+ T lymphocytes and fibrosis. CONCLUSIONS:AGL is an additional immune-related adverse event of anti-PD-1 therapy that leads to severe insulin resistance-associated complications.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Jehl A,Cugnet-Anceau C,Vigouroux C,Legeay AL,Dalle S,Harou O,Marchand L,Lascols O,Caussy C,Thivolet C,Laville M,Disse Edoi
10.2337/dc18-2535subject
Has Abstractpub_date
2019-10-01 00:00:00pages
2008-2010issue
10eissn
0149-5992issn
1935-5548pii
dc18-2535journal_volume
42pub_type
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