Anti-PD-1 treatment-induced immediate central diabetes insipidus: a case report

Modulating PD-1 expression can constrain tumor growth. Hodgkin lymphoma patients commonly express PD-L1 on tumor cells. We report the case of a 60-year-old male patient with relapsed classical Hodgkin lymphoma who suffered from immediate-onset chill, hyperthermia and polyuria following initial treatment with sintilimab, an anti-PD-1 monoclonal antibody. The results revealed central diabetes insipidus (cDI). After 3 months of treatment with glucocorticoids and desmopressin acetate, his symptoms and the results were consistent with the resolution of cDI and the treatment course was discontinued. Diabetes insipidus is a rare complication of immunotherapeutic treatment, and this is the first case report to our knowledge to have described immediate-onset cDI caused by anti-PD-1 treatment. Lay abstract For relapsed classical Hodgkin lymphoma, anti-PD-1 monoclonal antibodies have been related to potent safety profiles and efficacy. Reported here is a case of a 60-year-old man diagnosed as having relapsed classical Hodgkin lymphoma. He achieved a durable response over 4 months with four rounds of traditional chemotherapy, and then the disease relapsed. Sintilimab, an anti-PD-1 monoclonal antibody, was executed for salvage therapy. In spite of the patient-acquired durable response, central diabetes insipidus was detected after the first application of sintilimab. According to our knowledge this is the first case to report immediate-onset central diabetes insipidus caused by the treatment of anti-PD-1. In the present study, we discussed and analyzed the types and clinical causes of diabetes insipidus for this patient.

Automated summary

Modulating PD-1 expression can control tumor growth, but it may lead to rare complications like central diabetes insipidus. This case report highlights the immediate-onset central diabetes insipidus caused by anti-PD-1 treatment, which was successfully resolved with glucocorticoids and desmopressin acetate. Further studies are needed to understand the potential risks associated with anti-PD-1 therapy in Hodgkin lymphoma patients.