Diabetic ketoacidosis shortly after COVID-19 vaccination in a non-small-cell lung cancer patient receiving combination of PD-1 and CTLA-4 inhibitors: A case report

Thorac Cancer. 2022 Apr;13(8):1220-1223. doi: 10.1111/1759-7714.14352. Epub 2022 Feb 14.

Abstract

We describe a case of diabetic ketoacidosis (DKA) shortly after the SARS-CoV-2 (COVID-19) vaccination in a 65-year-old woman with non-small-cell lung cancer under a combination treatment of programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors. She had no history of diabetic mellitus. A few days after the second shot of COVID-19 vaccination, she developed DKA. We speculate that the immune-related adverse event and immunogenicity of vaccination synergistically induced DKA.

Keywords: COVID-19 vaccination; diabetic ketoacidosis; immune checkpoint inhibitor; immune-related adverse event.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19 Vaccines / adverse effects
  • COVID-19*
  • CTLA-4 Antigen / therapeutic use
  • Carcinoma, Non-Small-Cell Lung* / complications
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Diabetes Mellitus*
  • Diabetic Ketoacidosis* / chemically induced
  • Female
  • Humans
  • Immune Checkpoint Inhibitors
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Programmed Cell Death 1 Receptor / therapeutic use
  • SARS-CoV-2
  • Vaccination / adverse effects

Substances

  • COVID-19 Vaccines
  • CTLA-4 Antigen
  • Immune Checkpoint Inhibitors
  • Programmed Cell Death 1 Receptor