Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis
Abstract Interleukin‐6 is a pleiotropic cytokine that plays a pathogenic role in type 1 diabetes. Therefore, anti‐interleukin‐6 receptor antibody, tocilizumab, used for the treatment of rheumatoid arthritis, is considered a candidate for immune intervention in type 1 diabetes. Here, we report the ca...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-04-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13706 |
| _version_ | 1818058616726355968 |
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| author | Eiji Kawasaki Takahiro Fukuyama Aira Uchida Yoko Sagara Yuko Nakano Hidekazu Tamai Masayuki Tojikubo Yuji Hiromatsu Nobuhiko Koga |
| author_facet | Eiji Kawasaki Takahiro Fukuyama Aira Uchida Yoko Sagara Yuko Nakano Hidekazu Tamai Masayuki Tojikubo Yuji Hiromatsu Nobuhiko Koga |
| author_sort | Eiji Kawasaki |
| collection | DOAJ |
| description | Abstract Interleukin‐6 is a pleiotropic cytokine that plays a pathogenic role in type 1 diabetes. Therefore, anti‐interleukin‐6 receptor antibody, tocilizumab, used for the treatment of rheumatoid arthritis, is considered a candidate for immune intervention in type 1 diabetes. Here, we report the case of a 73‐year‐old woman (HLA‐DR9‐DQ3 homozygote) with well‐controlled rheumatoid arthritis who developed type 1 diabetes while receiving tocilizumab treatment. At 57 years‐of‐age, the patient was diagnosed with rheumatoid arthritis, for which she underwent tocilizumab therapy that enabled complete suppression of her joint inflammation. A total of 17 months after starting tocilizumab therapy, she noticed polydipsia, polyuria, general fatigue and weight reduction (−2 kg/month), and was diagnosed with type 1 diabetes with diabetic ketoacidosis based on an arterial pH of 7.26, serum ketone body of 7,437 μmol/L, blood glucose level of 925 mg/dL, glycated hemoglobin of 13.2% and the presence of anti‐islet autoantibodies. This case report shows valuable insight regarding the effect of anti‐interleukin‐6 receptor antibody therapy on type 1 diabetes prevention. |
| first_indexed | 2024-12-10T13:03:28Z |
| format | Article |
| id | doaj.art-6f3791905db6491caaa8af6a29ed0a8a |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-10T13:03:28Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-6f3791905db6491caaa8af6a29ed0a8a2022-12-22T01:47:55ZengWileyJournal of Diabetes Investigation2040-11162040-11242022-04-0113473874010.1111/jdi.13706Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritisEiji Kawasaki0Takahiro Fukuyama1Aira Uchida2Yoko Sagara3Yuko Nakano4Hidekazu Tamai5Masayuki Tojikubo6Yuji Hiromatsu7Nobuhiko Koga8Department of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanDepartment of Diabetes and Endocrinology Shin‐Koga Hospital Kurume JapanAbstract Interleukin‐6 is a pleiotropic cytokine that plays a pathogenic role in type 1 diabetes. Therefore, anti‐interleukin‐6 receptor antibody, tocilizumab, used for the treatment of rheumatoid arthritis, is considered a candidate for immune intervention in type 1 diabetes. Here, we report the case of a 73‐year‐old woman (HLA‐DR9‐DQ3 homozygote) with well‐controlled rheumatoid arthritis who developed type 1 diabetes while receiving tocilizumab treatment. At 57 years‐of‐age, the patient was diagnosed with rheumatoid arthritis, for which she underwent tocilizumab therapy that enabled complete suppression of her joint inflammation. A total of 17 months after starting tocilizumab therapy, she noticed polydipsia, polyuria, general fatigue and weight reduction (−2 kg/month), and was diagnosed with type 1 diabetes with diabetic ketoacidosis based on an arterial pH of 7.26, serum ketone body of 7,437 μmol/L, blood glucose level of 925 mg/dL, glycated hemoglobin of 13.2% and the presence of anti‐islet autoantibodies. This case report shows valuable insight regarding the effect of anti‐interleukin‐6 receptor antibody therapy on type 1 diabetes prevention.https://doi.org/10.1111/jdi.13706Interleukin‐6TocilizumabType 1 diabetes |
| spellingShingle | Eiji Kawasaki Takahiro Fukuyama Aira Uchida Yoko Sagara Yuko Nakano Hidekazu Tamai Masayuki Tojikubo Yuji Hiromatsu Nobuhiko Koga Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis Journal of Diabetes Investigation Interleukin‐6 Tocilizumab Type 1 diabetes |
| title | Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis |
| title_full | Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis |
| title_fullStr | Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis |
| title_full_unstemmed | Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis |
| title_short | Development of type 1 diabetes in a patient treated with anti‐interleukin‐6 receptor antibody for rheumatoid arthritis |
| title_sort | development of type 1 diabetes in a patient treated with anti interleukin 6 receptor antibody for rheumatoid arthritis |
| topic | Interleukin‐6 Tocilizumab Type 1 diabetes |
| url | https://doi.org/10.1111/jdi.13706 |
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