Diabetic ketoacidosis after the second dose of SARS-CoV-2 mRNA vaccination in a patient with pembrolizumab-induced fulminant type 1 diabetes.

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Diabetology International Pub Date : 2023-04-01 DOI:10.1007/s13340-022-00614-w

Kohei Nishino, Kimiko Nakagawa, Eriko Yase, Mariko Terashima, Takashi Murata

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引用次数: 3

Abstract

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.

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派姆单抗诱导的暴发性1型糖尿病患者第二次接种SARS-CoV-2 mRNA后的糖尿病酮症酸中毒

我们报告一例77岁女性暴发性1型糖尿病(T1D)患者在第二剂SARS-CoV-2疫苗tozinameran后发生糖尿病酮症酸中毒(DKA)。患者在75岁时被诊断为T1D，并伴有派姆单抗引起的免疫相关不良事件。在第二次给药后，她出现DKA，需要静脉注射胰岛素和机械通气。虽然在本病例中无法证实疫苗接种与DKA发作之间的直接因果关系，但已发表的文献表明，T1D患者接种SARS-CoV-2疫苗后可能发生DKA。由于SARS-CoV-2 mRNA疫苗的已知药物不良反应与T1D患者对病日状况的易感程度的组合风险程度尚未得到彻底评估，因此需要进行未来的研究，例如具有足够样本量的非介入性研究来解决这一问题。

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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.