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| Metronidazole Induced Hypoglycemia on an Elderly Patient without Diabetes |
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Jun Hyun Park, Sang Ah Lee |
Correspondence:
Sang Ah Lee,
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| Abstract |
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In the elderly, diabetes patients often experienced hypoglycemia due to medication. However, hypoglycemia can occur in a
wide variety of situations without diabetes such as these cases including heavy alcohol drinking, decreased liver function,
sepsis, pneumonia, and decreased renal function, etc. In this case, hypoglycemia occurred in treating with cefotaxime and
metronidazole in patients with abdominal pain due to intravascular embolism at the entrance of the superior mesenteric artery.
This hypoglycemia was accompanied by hyperinsulinemia. The possibility of other adrenal insufficiency was excluded because
of normal response in rapid ACTH test. Insulinoma was also excluded because of no experience of hypoglycemia before
admission and no tumor in pancreas in CT scan. In addition, renal function was recovering, so renal function was unlikely to be
a cause.We doubt the possibility of antimicrobial agents,cefotaxime and metronidazole, as a cause of hypoglycemia. Firstly, we
stopped cefotaxime, but continued hypoglycemia until day 3. And, as the next step, we quit the use of metronidazole and then
hypoglycemia was recovered. In this case, we suggested that hypoglycemia was related with metronidazole. Hypoglycemia
associated with metronidazole is mainly associated with the use of diabetes medications in previous cases, and few cases of
hypoglycemia in patients without such diabetes have been reported. Therefore, we report hypoglycemia associated with the use
of metronidazole in elderly patients without diabetes. |
| Key Words:
Elderly, Hyperinsulinemic, Hypoglycemia, Metronidazole |
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