免疫检查点抑制剂（ICIs）已越来越多地用于各种晚期癌症的治疗; 然而，治疗可能会因免疫相关不良事件（irAE）而变得复杂。我们介绍了一位40多岁男性的个案，他被诊断出转移性黑色素瘤并接受了尼伏单抗免疫疗法，但出现了ICI诱发的糖尿病（ICI-DM）症状。当他因荨麻疹前往急诊科复诊时，无酮症高血糖被意外发现。进一步的检查，包括血红蛋白A1c和C肽水平，证实他的病情最符合ICI-DM，并开始适当的糖尿病治疗。本报告旨在详细介绍ICI-DM的非典型表现，并强调临床医生意识在识别接受ICIs治疗的患者中的这种irAE问题的重要性。©BMJ Publishing Group Limited 2023。在CC BY-NC下允许再次使用。不允许商业再利用。由BMJ出版。

Immune checkpoint inhibitors (ICIs) have been increasingly used in the treatment of various advanced cancers; however, therapy can be complicated by immune-related adverse events (irAEs). We present the case of a man in his 40s, with metastatic melanoma treated with nivolumab immunotherapy who developed ICI-induced diabetes mellitus (ICI-DM). Hyperglycaemia in the absence of ketoacidosis was incidentally noted when he presented to the emergency department for review of an urticarial rash. Further testing, including haemoglobin A1c and C-peptide level, confirmed his presentation was most consistent with ICI-DM and he was commenced on appropriate diabetes treatment. This report aims to detail an atypical presentation of ICI-DM and to highlight the importance of clinician awareness in identifying this irAE in patients receiving ICIs.© BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.