Immunotherapy induced endocrinopathies: "pembrolizumab-induced pancreatitis presenting as diabetic ketoacidosis with concurrent hyperthyroidism-related atrial fibrillation"

Mohsin Mukhtar; Irbaz Nazir; Mirza Aftab; Colm McGurk

doi:10.1530/endoabs.99.EP872

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Endocrine Abstracts (2024) 99 EP872 | DOI: 10.1530/endoabs.99.EP872

ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)

Immunotherapy induced endocrinopathies: "pembrolizumab-induced pancreatitis presenting as diabetic ketoacidosis with concurrent hyperthyroidism-related atrial fibrillation"

Mohsin Mukhtar , Irbaz Nazir , Mirza Aftab & Colm McGurk

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St. Luke’s General Hospital, Kilkenny, Ireland

In this report, we discuss the case of a 77-year-old male with no previous history of diabetes or thyroid disease, undergoing pembrolizumab treatment for malignant melanoma. He presented to the emergency department in diabetic ketoacidosis (DKA) and shock after five days of vomiting, unable to eat or drink. Laboratory findings indicated severe metabolic disturbances, including high blood glucose and amylase levels, consistent with pembrolizumab-induced pancreatitis and subsequent pancreatic insufficiency leading to DKA. Additionally, the patient developed new-onset rapid atrial fibrillation and a thyroid profile indicative of hyperthyroidism, presumably secondary to the immunotherapy. He was successfully managed with a DKA protocol and intensive care, highlighting the complexity of treating immune checkpoint inhibitor-induced endocrine complications and the importance of a multidisciplinary approach in such cases