Pembrolizumab related central diabetes insipidus

Abstract

Chen Han Yong, Anas Alawawdeh, Parind Vora, Christopher Hocking

This case report describes a case of anti-programmed cell death protein 1 (PD-1) antibody-related central diabetes insipidus without features of infiltrative process on neuroimaging. It involved a 63-year old man who was initially admitted for immunotherapy-related pneumonitis and was subsequently diagnosed with new central diabetes insipidus on the background of advanced non-small cell lung cancer treated with pembrolizumab. This clinical phenomenon is exceedingly rare and has been reported with anti-cytotoxic T lymphocytes-4 (CTLA-4) agent [1]. Central diabetes insipidus associated with anti-PD-1 monotherapy has only been described in three case reports [2-4]. Neuroimaging plays an important role to identify other process including metastatic infiltration. Multi-disciplinary patient care remains the key in managing patients with immunotherapyrelated endocrinopathies.

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