Journal article
New-Onset Autoantibody-Negative Diabetes With DKA Following Lorlatinib Therapy for ALK-Positive NSCLC
Case reports in endocrinology, v 2025(1), 8034190
01 Jan 2025
PMID: 41322009
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Lorlatinib, a tyrosine kinase inhibitor used in anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC), is associated with adverse events, including hyperglycemia. We present a case of a 52-year-old male with stage IV NSCLC and brain metastases who developed diabetic ketoacidosis (DKA) following lorlatinib initiation. The patient, without prior diabetes, presented with hyperglycemia (792 mg/dL), metabolic acidosis, and ketonuria 2 months after starting lorlatinib. He was treated for DKA and subsequently transitioned to a basal-bolus insulin regimen. Lorlatinib was withheld transiently and restarted once acute symptoms resolved. This case, along with three reported cases of lorlatinib-induced hyperglycemia, highlights a rare but serious potential complication. The mechanism of lorlatinib-induced hyperglycemia is unclear but may involve reduced insulin secretion. This case underscores the importance of monitoring for hyperglycemia in patients receiving lorlatinib, even in the absence of pre-existing diabetes, to enable early detection and prevent life-threatening complications like DKA.
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Details
- Title
- New-Onset Autoantibody-Negative Diabetes With DKA Following Lorlatinib Therapy for ALK-Positive NSCLC
- Creators
- Ashni Dharia - Allegheny Gen Hosp, Dept Internal Med, Allegheny Hlth Network, 320 E North Ave, Pittsburgh, PA USAAnna Pleet - Allegheny Gen Hosp, Dept Internal Med, Allegheny Hlth Network, 320 E North Ave, Pittsburgh, PA USABrittany West - Allegheny Gen Hosp, Allegheny Hlth Network, Dept Pathol, 320 E North Ave, Pittsburgh, PA 15212 USAGayatri Jaiswal - Allegheny Gen Hosp, Allegheny Hlth Network, Dept Pathol, 320 E North Ave, Pittsburgh, PA 15212 USA
- Publication Details
- Case reports in endocrinology, v 2025(1), 8034190
- Publisher
- Wiley
- Number of pages
- 5
- Grant note
- Highmark Health (Pittsburgh, PA, United States of America)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:001618705200001
- Scopus ID
- 2-s2.0-105022663765
- Other Identifier
- 991022138572904721
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- Web of Science research areas
- Endocrinology & Metabolism