New-onset autoimmune diabetes and fatal pathologic pneumatosis after recent durvalumab lung cancer treatment in the United States: a case report
Year: 2026
Type: article
Study design: Case Report
Abstract: A 66-year-old man presented with diabetic ketoacidosis due to new-onset type 1 diabetes mellitus following recent immunotherapy with durvalumab for lung cancer. Imaging revealed incidental pneumatosis intestinalis and elevated lactate levels in the setting of a benign abdominal examination. Mesenteric ischemia was later confirmed during surgical exploration, necessitating multiple operations and repeat bowel resections. The bowel was left in discontinuity with temporary abdominal closure, and the patient was admitted to the intensive care unit. Ultimately, the course was fatal due to insufficient viable bowel length to sustain life. This case highlights two rare but critical immune-mediated adverse effects likely associated with the recent initiation of durvalumab, a programmed death ligand 1 (PDL1) inhibitor, for lung cancer treatment. The development of new autoimmunity or coagulopathy in patients recently treated with PD-L1 immunotherapy for cancer should prompt consideration of a potential causal relationship and early multidisciplinary discussion involving surgery and hematology-oncology.
Source: JOURNAL OF ACUTE CARE SURGERY
Authors: Lauren R. Moore, Manuel Martinez
Institution: Geisinger Medical Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7140050027