Immune Checkpoint inhibitors (ICIs) such as nivolumab, pembrolizumab, and ipilimumab are monoclonal antibodies against cytotoxic T lymphocyte antigen 4 (CTLA4) or program death (PD)1 and its ligand PDL1. Agents targeting PD1, such as pembrolizumab, have shown widespread efficacy in the past and are also associated with a wide range of immune-related adverse events (irAEs), including endocrine toxicities. A 31-year-old female with a medical history significant for Stage IIb Breast cancer on chemo and immunotherapy (pembrolizumab) presented with nausea, vomiting, and generalized abdominal pain. Laboratory studies showed a blood glucose level of 356 mg/dl, elevated Anion gap 18 meq/L, beta-hydroxybutyrate 46mg/d, and low C-peptide levels
Tayyeb, Muhammad; Tariq, Maham; Khan, Ahsan M; Khalid, Farhan; Meghal, Trishala; and Du, Doantrang MD, FACP
"When Hormones are Being Difficult: A Rare Case and the Literature Review of Pembrolizumab-Induced Polyendocrinopathy,"
Journal of Community Hospital Internal Medicine Perspectives: Vol. 13:
6, Article 21.
Available at: https://scholarlycommons.gbmc.org/jchimp/vol13/iss6/21