Recurrent hypoglycemia in a hemodialysis patient related to propoxyphene treatment.
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.
Lee
Hui-Ting
HT
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Tseng
Wei-Cheng
WC
Tarng
Der-Cherng
DC
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
D000701:Analgesics, Opioid; D011431:Dextropropoxyphene