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Review
. 2024;84(1):138-142.

[Diabetic ketoacidosis secondary to immunotherapy]

[Article in Spanish]
Agustina Benitez Cruz  1 , Débora Pellegrini  2 , Maricel Recalde  3 , Mariana Rella  2 , Melina Saban  3
Affiliations
  • PMID: 38271940
Free article
Review

[Diabetic ketoacidosis secondary to immunotherapy]

[Article in Spanish]
Agustina Benitez Cruz et al. Medicina (B Aires). 2024.
Free article

Abstract
in English, Spanish

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that are increasingly used in cancer treatments. As experience in the use of immunotherapy increases, more is known about its safety profile and immune-mediated adverse effects. Among them is diabetic ketoacidosis (DKA), a rare but serious fatal complication of treatment. In this paper we describe the cases of three patients who presented with episodes of DKA during treatment with ICIs, two of which manifested with fulminant forms, leading to an acute course with initially normal glycosylated hemoglobin values. In addition, we conducted a review of the literature on DKA associated with ICIs in order to highlight the importance of noticing these potentially fatal complications and promptly establishing appropriate therapy.

Los inhibidores de puntos de control inmune (ICIs) son anticuerpos monoclonales cada vez más utilizados en tratamientos oncológicos. A medida que aumenta la experiencia en el uso de inmunoterapia, se conoce cada vez más su perfil de seguridad y los efectos adversos inmunomediados. Entre ellos se encuentra la cetoacidosis diabética (CAD), complicación infrecuente, grave y potencialmente mortal. En este trabajo describimos los casos de tres pacientes que se presentaron con episodios de CAD durante el tratamiento con ICIs, dos de los cuales manifestaron con formas fulminantes, llevando un curso agudo con valores de hemoglobina glicosilada inicialmente normales. Asimismo, realizamos una revisión de la literatura sobre la CAD asociada a ICIs a fines de resaltar la importancia de advertir estas complicaciones potencialmente fatales e instaurar rápidamente la terapéutica apropiada.

Keywords: diabetic ketoacidosis; fulminant diabetes; immune checkpoint inhibitors; immunotherapy.

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