Trimethoprim-sulfamethoxazole induced prolonged hypoglycemia in an infant with MHC class II deficiency: diazoxide as a treatment option.
Hyperinsulinemic hypoglycemia associated with trimethoprim-sulfamethoxazole (TMP-SMX) has generally been reported in adults who had renal impairment or in patients with AIDS using high dose TMP-SMX. We present a 5 month-old infant with immunodeficiency due to major histocompatibility complex class II expression defect, developing hypoglycemic convulsion on the third day of high dose TMP-SMX administration. High insulin and C-peptide levels were documented at the time of hypoglycemia. To overcome hypoglycemia while TMP-SMX tapered off, diazoxide was administered which resolved hypoglycemia in 2 months.
Gonc
E Nazli
EN
Division of Pediatric Endocrinology, Hacettepe University Faculty of Medicine, Ankara, Turkey. ngonc@hacettepe.edu.tr
Turul
Tuba
T
Yordam
Nursen
N
Ersoy
Fugen
F
D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003981:Diazoxide / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D015870:Gene Expression; D005802:Genes, MHC Class II / Q000235:genetics; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006760:Hospitalization; D006801:Humans; D006946:Hyperinsulinism / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D007003:Hypoglycemia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics; D007223:Infant; D007262:Infusions, Intravenous; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy; D012640:Seizures / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000627:therapeutic use
D001786:Blood Glucose; D002096:C-Peptide; D000949:Histocompatibility Antigens Class II; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D005947:Glucose; D003981:Diazoxide