TY - JOUR
T1 - Sulfasalazine-Induced Hypoglycemia in a Patient with Type 2 Diabetes and End-Stage Renal Disease
AU - Stamatiades, George A.
AU - Echouffo-Tcheugui, Justin B.
AU - Garber, Jeffrey R.
N1 - Funding Information:
Author contributions: George A. Stamatiades and Justin B. Echouffo-Tcheugui researched the data. George A. Stamatiades wrote the manuscript. Jeffrey R. Garber contributed to the discussion and reviewed and edited the manuscript. George A. Stamatiades, Justin B. Echouffo-Tcheugui, and Jeffrey R. Garber are the guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objective: To demonstrate important points regarding the possible hypoglycemic effects of sulfasalazine and suggest possible underlying mechanism(s) accounting for sulfasalazine-induced hypoglycemia. Methods: We describe a case of reversible sulfasalazine-induced hypoglycemia, review the literature, and discuss a potential mechanism accounting for sulfasalazine-induced hypoglycemia. Results: A 63-year-old man with Crohn disease treated with sulfasalazine and type 2 diabetes complicated by end-stage renal disease was admitted for treatment of persistent hypoglycemia. Insulinoma was initially suspected, but localization studies including endoscopic ultrasound were negative. This raised the possibility of sulfasalazine-induced hypoglycemia. Three days after sulfasalazine was stopped, he became normoglycemic. Hypoglycemia has not recurred since discontinuing sulfasalazine. Conclusion: Clinicians should be aware of the potential hypoglycemic effect of sulfasalazine. Doses should be reduced in patients with impaired renal function, and it should be discontinued if otherwise unexplained hypoglycemia develops. Abbreviations: CT = computed tomography; ESRD = end-stage renal disease
AB - Objective: To demonstrate important points regarding the possible hypoglycemic effects of sulfasalazine and suggest possible underlying mechanism(s) accounting for sulfasalazine-induced hypoglycemia. Methods: We describe a case of reversible sulfasalazine-induced hypoglycemia, review the literature, and discuss a potential mechanism accounting for sulfasalazine-induced hypoglycemia. Results: A 63-year-old man with Crohn disease treated with sulfasalazine and type 2 diabetes complicated by end-stage renal disease was admitted for treatment of persistent hypoglycemia. Insulinoma was initially suspected, but localization studies including endoscopic ultrasound were negative. This raised the possibility of sulfasalazine-induced hypoglycemia. Three days after sulfasalazine was stopped, he became normoglycemic. Hypoglycemia has not recurred since discontinuing sulfasalazine. Conclusion: Clinicians should be aware of the potential hypoglycemic effect of sulfasalazine. Doses should be reduced in patients with impaired renal function, and it should be discontinued if otherwise unexplained hypoglycemia develops. Abbreviations: CT = computed tomography; ESRD = end-stage renal disease
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U2 - 10.4158/ACCR-2018-0067
DO - 10.4158/ACCR-2018-0067
M3 - Article
AN - SCOPUS:85124247673
SN - 2376-0605
VL - 4
SP - e493-e496
JO - AACE Clinical Case Reports
JF - AACE Clinical Case Reports
IS - 6
ER -