Hypoglycemia due to hydroxychloroquine, an uncommon association but to keep in mind, case report and review of literature

Abstract

Case presentation Female patient years old in treatment for an Indeterminate Connective Tissue Disease with Deflazacort and Hydroxychloroquine It began with a compatible clinical presentation of hypoglycemia objectified between and mg dl Fasting test rules out the biochemical possibility of insulinoma and with no findings that suggest obvious disease that is responsible for hypoglycemia It is attributed to hydroxychloroquine which is suspended Soon the clinical presentation of hypoglycemia disappears and the patient remains asymptomatic Discussion The study of hypoglycemia in a context of a non diabetic patient is always a challenge A correct medical history and physical examination can give clues about the origin of hypoglycemia Within the differential diagnosis are the uses of medications that cause hypoglycemia One of them hydroxychloroquine widely used for the treatment of rheumatic diseases has been described as causing hypoglycemia although it is a rare occurrence with this drug but it is well documented in the literature We review the cases described in the literature and the mechanisms that may explain hydroxychloroquine hypoglycemia