Tooth discoloration in patients with neonatal diabetes after transfer onto glibenclamide: a previously unreported side effect.
OBJECTIVE To assess if tooth discoloration is a novel side effect of sulfonylurea therapy in patients with permanent neonatal diabetes due to mutations in KCNJ11. RESEARCH DESIGN AND METHODS A total of 67 patients with a known KCNJ11 mutation who had been successfully transferred from insulin injections onto oral sulfonylureas were contacted and asked about the development of tooth discoloration after transfer. RESULTS Altered tooth appearance was identified in 5 of the 67 patients. This was variable in severity, ranging from mild discoloration/staining (n = 4) to loss of enamel (n = 1) and was only seen in patients taking glibenclamide (glyburide). CONCLUSIONS These previously unreported side effects may relate to the developing tooth and/or to the high local concentrations in the children who frequently chewed glibenclamide tablets or took it as a concentrated solution. Given the multiple benefits of sulfonylurea treatment for patients with activating KCNJ11 mutations, this association warrants further investigation but should not preclude such treatment.
Institute of Biomedical and Clinical Science, Peninsula Medical School, Exeter, U.K.
Janani
J
Kumaraguru
Sarah E
SE
Flanagan
Siri Atma W
SA
Greeley
Roos
R
Nuboer
Julie
J
Støy
Louis H
LH
Philipson
Andrew T
AT
Hattersley
Oscar
O
Rubio-Cabezas
D003744:Dental Enamel Hypoplasia / Q000139:chemically induced; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000235:genetics; D005905:Glyburide / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D009154:Mutation; D024661:Potassium Channels, Inwardly Rectifying / Q000235:genetics*; D014075:Tooth Discoloration / Q000139:chemically induced*; D000099161:Kcnj11 Channel
D005905:Glyburide; D007328:Insulin; D024661:Potassium Channels, Inwardly Rectifying; D000099161:Kcnj11 Channel