Diabetic ketoacidosis after the second dose of SARS-CoV-2 mRNA vaccination in a patient with pembrolizumab-induced fulminant type 1 diabetes
Tóm tắt
We report a case of 77-year-old woman with fulminant type 1 diabetes (T1D) who developed diabetic ketoacidosis (DKA) after the second dose of SARS-CoV-2 vaccine tozinameran. The patient had been diagnosed as having T1D associated with an immune-related adverse event caused by pembrolizumab at the age of 75. After the second dose of tozinameran, she developed DKA and needed intravenous insulin infusion and mechanical ventilation. Although the direct causal relationship between the vaccination and the DKA episode could not be proven in this case, published literatures had suggested the possibility of developing DKA after SARS-CoV-2 vaccination in patients with T1D. As the magnitude of the risk of the combination of the known adverse drug reactions of SARS-CoV-2 mRNA vaccine and T1D patients’ vulnerability to sick-day conditions is not yet thoroughly assessed, future studies such as a non-interventional study with adequate sample size would be required to address this issue.
Tài liệu tham khảo
Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32:1335–43.
Hughes J, Vudattu N, Sznol M, et al. Precipitation of autoimmune diabetes with anti-PD1 immunotherapy. Diabetes Care. 2015;38:55–7.
Gaudy C, Clévy C, Monestier S, et al. Anti-PD1 pembrolizumab can induce exceptional fulminant type 1 diabetes. Diabetes Care. 2015;38:e182–3.
Ikegami H, Kawabata Y, Noso S. Immune checkpoint therapy and type 1 diabetes. Diabetol Int. 2016;7:221–7.
Baden M, Imagawa A, Abiru N, et al. Characteristics and clinical course of type 1 diabetes mellitus related to anti-programmed cell death-1 therapy. Diabetol Int. 2019;10:58–66.
Benfield T, Jensen JS, Nordestgaard BG. Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome. Diabetologia. 2007;50:549–54.
Shah BR, Janet EH. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003;26:510–3.
Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab. 2012;16(Suppl 1):S27-36.
Selvin E, Juraschek SP. Diabetes epidemiology in the COVID-19 pandemic. Diabetes Care. 2020;43:1690–4.
Matsunaga N, Hayakawa K, Terada M, et al. Clinical epidemiology of hospitalized patients with COVID-19 in Japan: Report of the COVID-19 REGISTRY JAPAN. Clin Infect Dis. 2021;73(11):e3677–89.
Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020;323:1775–6.
Kumar A, Arora A, Sharma P, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr. 2020;14:535–45.
Huang I, Anthonius M, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020;14:395–403.
Coleman JJ, Pontefract SK. Adverse drug reactions. Clin Med (Lond). 2016;16:481–5.
Phillips R, Hazell L, Sauzet O, Cornelius V. Analysis and reporting of adverse events in randomised controlled trials: a review. BMJ Open. 2019;9: e024537.
Bardeles JC, Gee J, Myers T. Reactogenicity following receipt of mRNA-Based COVID-19 vaccines. JAMA. 2021;325(21):2201–2.
Zilbermint M, Demidowich AP. Severe diabetic ketoacidosis after the second dose of mRNA-1273 COVID-19 vaccine. J Diabetes Sci Technol. 2022. https://doi.org/10.1177/19322968211043552.
Ganakumar V, Jethwani P, Roy A, et al. Diabetic ketoacidosis (DKA) in type 1 diabetes mellitus (T1DM) temporally related to COVID-19 vaccination. Diabetes Metab Syndr. 2022;16(1): 102371.
Yano M, Morioka T, Natsuki Y, et al. A case of new-onset type 1 diabetes after Covid-19 mRNA vaccination. Intern Med. 2022. https://doi.org/10.2169/internalmedicine.9004-21.
Potier L, Julla JB, Roussel R, et al. COVID-19 symptoms masking inaugural ketoacidosis of type 1 diabetes. Diabetes Metab. 2021;47(1): 101162.
Ebekozien OA, Noor N, Gallagher MP, Alonso GT. Type 1 diabetes and COVID-19: preliminary findings from a multicenter surveillance study in the U.S. Diabetes Care. 2020;43:e83–5.
Chang LS, Sousa RB, Tolaney SM, Hodi FS, Kaiser UB, Min L. Endocrine toxicity of cancer immunotherapy targeting immune checkpoints. Endocr Rev. 2019;40(1):17–65.
Chong CR, Park VJ, Cohen B, Postow MA, Wolchok JD, Kamboj M. Safety of Inactivated influenza vaccine in cancer patients receiving immune checkpoint inhibitors. Clin Infect Dis. 2020;70(2):193–9.
Waissengrin B, Agbarya A, Safadi E, Padova H, Wolf I. Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors. Lancet Oncol. 2021;22(5):581–3.