Acquired Generalized Lipodystrophy: A New Cause of Anti-PD-1 Immune-Related Diabetes.

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 Care

journal_title

Diabetes care

authors

Jehl A,Cugnet-Anceau C,Vigouroux C,Legeay AL,Dalle S,Harou O,Marchand L,Lascols O,Caussy C,Thivolet C,Laville M,Disse E

doi

10.2337/dc18-2535

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

2008-2010

issue

10

eissn

0149-5992

issn

1935-5548

pii

dc18-2535

journal_volume

42

pub_type

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