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DC Field | Value | Language |
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dc.contributor.author | Wu, L. | - |
dc.contributor.author | Wu, Linda | - |
dc.contributor.author | Carlino, Matteo S. | - |
dc.contributor.author | Brown, David Alexander | - |
dc.contributor.author | Brown, D. A. | - |
dc.contributor.author | Long, G. V. | - |
dc.contributor.author | Clifton-Bligh, R. | - |
dc.contributor.author | Mellor, Rhiannon | - |
dc.contributor.author | Moore, Krystal | - |
dc.contributor.author | Sasson, Sarah Christina | - |
dc.contributor.author | Menzies, A. M. | - |
dc.contributor.author | Tsang, Venessa | - |
dc.contributor.author | Gunton, Jenny Elizabeth | - |
dc.date.accessioned | 2024-05-16T03:11:31Z | - |
dc.date.available | 2024-05-16T03:11:31Z | - |
dc.date.issued | 2024 | - |
dc.identifier.uri | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/9649 | - |
dc.description.abstract | OBJECTIVE: To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM). RESEARCH DESIGN AND METHODS: Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as defined by (1) previous immune checkpoint inhibitor (ICI) therapy, (2) new-onset hyperglycemia (blood glucose level >= 11.1 mmol/L and/or glycosylated hemoglobin >= 6.5%), and (3) insulin deficiency [C-peptide <0.4 nmol/L or diabetic ketoacidosis (DKA)] within 1 month of presentation. Pancreatic volume was available and measured using computed tomography volumetry for 17 patients with CIADM and 3 sets of control patients: 7 with ICI-related pancreatitis, 13 with asymptomatic ICI-related lipase elevation, and 11 ICI-treated controls for comparison. RESULTS: All patients had either anti-programmed cell death protein 1 or anti-programmed cell death ligand 1 therapy. Median time from ICI commencement to CIADM diagnosis was 15 weeks. At presentation, 25 (69%) had DKA, 27 (84%) had low C-peptide, and, by 1 month, 100% had low C-peptide. Traditional type 1 diabetes autoantibodies were positive in 15/35 (43%). Lipase was elevated in 13/27 (48%) at presentation. In 4 patients with longitudinal lipase testing, elevated levels peaked 1 month prior to CIADM diagnosis. Pancreatic volume was lower pre-ICI in CIADM patients compared with controls and demonstrated a mean decline of 41% from pretreatment to 6 months post-CIADM diagnosis. CONCLUSION: Pronounced biochemical and radiologic changes occur during CIADM pathogenesis. Rapid loss of C-peptide is a distinct characteristic that can be used to aid diagnosis as autoantibodies are often negative. | - |
dc.subject | Diabetes Mellitus, Type 1 | - |
dc.subject | C-Peptide | - |
dc.subject | Diabetic Ketoacidosis | - |
dc.subject | Autoantibodies | - |
dc.subject | Atrophy | - |
dc.subject | Lipase | - |
dc.title | Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy | - |
dc.type | Journal Article | - |
dc.identifier.doi | Endocrinology | - |
dc.identifier.doi | Oncology | - |
dc.identifier.doi | Immunology | - |
dc.identifier.doi | Radiology | - |
dc.identifier.journaltitle | Journal of Clinical Endocrinology & Metabolism | - |
dc.identifier.department | Journal of Clinical Endocrinology & Metabolism 109(5):1301-1307, 2024 | - |
dc.contributor.wslhd | Wu, Linda | - |
dc.contributor.wslhd | Carlino, Matteo S. | - |
dc.contributor.wslhd | Brown, David Alexander | - |
dc.contributor.wslhd | Mellor, Rhiannon | - |
dc.contributor.wslhd | Moore, Krystal | - |
dc.contributor.wslhd | Sasson, Sarah Christina | - |
dc.contributor.wslhd | Tsang, Venessa | - |
dc.contributor.wslhd | Gunton, Jenny Elizabeth | - |
dc.type.studyortrial | Multicenter Study | - |
dc.identifier.pmid | 37997380 | - |
dc.identifier.facility | Westmead | - |
Appears in Collections: | Westmead Hospital 2019 - 2024 |
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