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Case Reports: Adverse drug reactions and complications
Severe insulin resistance in a patient with diabetes after treatment with brentuximab vedotin
  1. Greet Peeters and
  2. Ann Verhaegen
  1. Endocrinology-Diabetology, ZNA Jan Palfijn, Merksem, Belgium
  1. Correspondence to Dr Greet Peeters; greet.peeters{at}zna.be

Abstract

A man in his late 60s with a history of well-controlled type 2 diabetes and hepatic cirrhosis presented to the emergency department due to uncontrollable hyperglycaemia following the initial brentuximab vedotin (BV) infusion. BV was initiated as a treatment for mycosis fungoides, a form of cutaneous T-cell lymphoma. The patient was diagnosed with severe hyperglycaemia with ketosis. Empiric treatment with amoxicillin-clavulanic acid, hydration and intravenous insulin infusion was initiated. Hyperglycaemia persisted despite receiving massive amounts of insulin and was corrected only after treatment with high-dose methylprednisolone for suspected type B insulin resistance. Extremely high and difficult-to-treat hyperglycaemia is a rare side effect of BV. Unfortunately, the patient died of upper gastrointestinal bleeding 22 days after discharge. In patients with obesity and/or diabetes mellitus, the blood glucose levels should be carefully monitored when treated with BV.

  • Haematology (drugs and medicines)
  • Diabetes
  • Malignant and Benign haematology
  • Unwanted effects / adverse reactions

https://doi.org/10.1136/bcr-2022-251867

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    Footnotes

    • Contributors GP did the follow-up of the patient before and during the hospitalisation of the patient of the article, did the research for the article, wrote the article, made the figure. AV launched the idea to write the article, supervised, helped write the article, made corrections and suggestions, finalised the list of authors. MDK and NG did the follow-up of the patient before the hospitalisation and were also consulted during the hospitalisation; they also read the article for submission of the article .

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.