title: Two additional cases of metformin-associated encephalopathy in patients with end-stage renal disease undergoing hemodialysis.
abstract: We report on two additional cases of metformin-associated encephalopathy in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Two patients were seen at our hospital with abnormal neurological signs and symptoms. Magnetic resonance imaging (MRI) revealed the same pattern of high signal intensity in both basal ganglia in T2-weighted images in the two patients. The two patients had started taking metformin 5 and 6 weeks earlier at the same dose of 1000 mg per day. Metformin was immediately stopped, and regular hemodialysis was conducted. Their signs and symptoms resolved completely after these measures. The high signal intensity in both ganglia in T2-weighted MRI also disappeared. We should suspect metformin-induced encephalopathy and withdraw the drug when presented with diabetic patients with chronic kidney disease and neurological signs and symptoms of unknown cause.
authors.affiliation: Department of Internal Medicine, School of Medicine Gyeongsang National University, Jinju City, Gyeongsangnam-do, South Korea.
authors.forename: Yeo-Jin
authors.initials: YJ
authors.lastname: Kang
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Bae
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Seo
authors.forename: Dae-Hong
authors.initials: DH
authors.lastname: Jeon
authors.forename: Hyun Seop
authors.initials: HS
authors.lastname: Cho
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Se-Ho
authors.initials: SH
authors.lastname: Chang
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Park
mesh_terms: D001927:Brain Diseases / Q000150:complications / Q000473:pathology; D000075202:Contraindications; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008687:Metformin / Q000009:adverse effects*; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin