title: Symptomatic hypoglycemia: an unusual side effect of oral purine analogues for treatment of ALL.
abstract: Symptomatic hypoglycemia is an unusual complication in children receiving oral purine analogues for treatment of childhood acute lymphoblastic leukemia (ALL). The exact mechanism of the hypoglycemic effect of the antimetabolic therapy remains unclear. Reduced hepatic glycogen stores or impaired hepatic glyconeogenesis may partly explain the hypoglycemia. To prevent hypoglycemia, food containing complex carbohydrates is recommended before sleep. In severe cases of hypoglycemia due to 6-mercaptopurine (6-MP), the dose can be given in the morning and if this fails 6-MP can be discontinued for a short period of time. We report a 3-year-old child who developed severe early morning hypoglycemia episodes that resolved after decreasing 6-MP while receiving non-high risk ALL therapy.
authors.affiliation: Faculty of Medicine, Yüzüncü Yil University, Van, Turkey. bayalibay@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Bay
authors.forename: Ahmet Faik
authors.initials: AF
authors.lastname: Oner
authors.forename: Yasar
authors.initials: Y
authors.lastname: Cesur
authors.forename: Murat
authors.initials: M
authors.lastname: Dogan
authors.forename: Ozdal
authors.initials: O
authors.lastname: Etlik
authors.forename: Fatih
authors.initials: F
authors.lastname: Sanli
mesh_terms: D000284:Administration, Oral; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D015122:Mercaptopurine