TY - JOUR T1 - Rapid onset type-1 diabetes and diabetic ketoacidosis secondary to nivolumab immunotherapy: a review of existing literature JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-229568 VL - 12 IS - 8 SP - e229568 AU - Hafez Mohammad Ammar Abdullah AU - Radowan Elnair AU - Uzma Ikhtiar Khan AU - Muhammad Omar AU - Oscar L Morey-Vargas Y1 - 2019/08/01 UR - http://casereports.bmj.com/content/12/8/e229568.abstract N2 - Nivolumab is a programmed cell death receptor (PD-1) inhibitor that is increasingly used for various malignancies, both as a first line agent and as salvage therapy. Being a PD-1/PD-1 ligand checkpoint inhibitor, it is known to cause autoimmune inflammation of various organs and has been associated with thyroiditis, insulitis, colitis, hepatitis and encephalitis to name a few. There are increasing reports of nivolumab leading to acute onset fulminant type 1 diabetes and diabetic ketoacidosis (DKA). We present a case of a 68-year-old man who developed DKA after 2 doses of nivolumab for metastatic melanoma. He was found to have type 1 diabetes, but no diabetes related antibodies were positive. He recovered from diabetes and continues to use insulin 1 year after his diagnosis. This case and associated review illustrates the importance of educating and monitoring patients who start nivolumab therapy regarding this potentially life threatening complication. ER -