Refractory hypoglycemia induced by tigecycline in a peritoneal dialysis patient
10.3760/cma.j.cn114015-20201230-01300
- VernacularTitle:替加环素致腹膜透析患者顽固性低血糖
- Author:
Shan RAN
1
;
Ming ZHANG
;
Zhigao HE
Author Information
1. 复旦大学附属金山医院临床药学室，上海 201508
- Publication Type:Journal Article
- Keywords:
Tigecycline;
Hypoglycemia;
Peritoneal dialysis
- From:
Adverse Drug Reactions Journal
2021;23(10):555-557
- CountryChina
- Language:Chinese
-
Abstract:
A 78-year-old male patient with peritoneal dialysis received Juhong Tanke (橘红痰咳液) solution 10 ml thrice daily and 4 Jinqiaomai tablets (金荞麦片) thrice daily orally because of cough at night for 3 weeks(conventional abdominal dialysis maintenance treatment was given according to the original schedule). On day 5 of treatments, the peritoneal exudate was turbid. Laboratory tests showed white blood cell count (WBC) 1.1×10 9/L, neutrophils 0.65, hemoglobin (Hb) 105 g/L, platelet count (PLT) 90×10 9/L, high sensitivity C-reactive protein 26.9 mg/L, and procalcitonin 10.89 mg/L; the examination for exudate showed WBC 13 131×10 6/L and neutrophils 0.96. Acute diffuse peritonitis was diagnosed. Meropenem, moxifloxacin, norvancomycin, vancomycin, and linezolid were given successively along with the peritoneal dialysis, the infection was still not well controlled, and then the anti-infective drugs were changed to an IV infusion of tigecycline 50 mg twice daily. On day 9 of tigecycline treatment, the patient had sudden cold sweats and palpitations with fatigue, dizziness, and hunger. The peripheral blood glucose level was 2.0 mmol/L. An intravenous injection of 50% glucose was given and the blood glucose increased to 5.8 mmol/L. The patient had no history of diabetes mellitus, it was considered that hypoglycemia was related to tigecycline. Then tigecycline was discontinued and replaced by oral rifampicin 0.45 g thrice daily and an IV infusion of vancomycin 500 mg dissolved in 0.9% sodium chloride injection 100 ml once every 12 hours. Three days after tigecycline withdrawal, the patient′s blood glucose level was 3.0 mmol/L at dawn. Intravenous and oral glucose supplementation treatments were continued, and 19 days later, the patient′s fasting blood glucose level was 4.8-6.3 mmol/L.
