title: Recurrent hypoglycemia in a hemodialysis patient related to propoxyphene treatment.
abstract: There are various etiologies for hypoglycemia in patients with chronic renal failure, and its pathogenesis is complex. Concomitant use of medications is the most common cause. We report a rare case of an 82-year-old woman with type 2 diabetes mellitus in end-stage renal disease undergoing maintenance hemodialysis, who experienced recurrent symptomatic hypoglycemia during treatment with propoxyphene for pain relief. Hypoglycemia occurred simultaneously with elevated levels of serum immunoreactive insulin and C-peptide. After discontinuing propoxyphene, hypoglycemia mitigated and the level of insulin returned to normal range. Our case reminds us that propoxyphene-induced hypoglycemia should not be ignored, especially in hemodialysis patients with cold sweats, agitation and depressed consciousness.
authors.affiliation: Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Hui-Ting
authors.initials: HT
authors.lastname: Lee
authors.forename: Wei-Cheng
authors.initials: WC
authors.lastname: Tseng
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects*; D011431:Dextropropoxyphene / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D012008:Recurrence; D006435:Renal Dialysis
chemical_list: D000701:Analgesics, Opioid; D011431:Dextropropoxyphene