Abstract
BackgroundWe report a case of a patient with recurrent severe hypoglycemia after initiating the drug rasagiline (Azilect) for Parkinson disease.Case presentationA 25-year-old Emirati woman who had been diagnosed with Parkinson disease due to a genetic mutation since the age of 18 years presented to our hospital. She had been treated with a rotigotine patch 2 mg per day along with carbidopa + levodopa + entacapone 25 mg/100 mg/200 mg (Stalevo) over these years. Recently, her Stalevo had been changed to rasagiline (a monoamine oxidase B inhibitor). Soon after this change, she started experiencing recurrent documented severe hypoglycemia requiring hospitalization. Her hypoglycemic symptoms completely disappeared after 5–7 days of drug withdrawal. Despite detailed evaluation, no other causal relationship was documented except for rasagiline.ConclusionsTo the best of our knowledge, this case report documents an unknown association between rasagiline and hypoglycemia.
Highlights
We report a case of a patient with recurrent severe hypoglycemia after initiating the drug rasagiline (Azilect) for Parkinson disease.Case presentation: A 25-year-old Emirati woman who had been diagnosed with Parkinson disease due to a genetic mutation since the age of 18 years presented to our hospital
Many drugs have been reported as a cause of hypoglycemia, including quinine, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors, as well as antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) [4]
We report a case of a patient with recurrent hypoglycemic events following the introduction of the MAOI rasagiline
Summary
Severe hypoglycemia is a frequently encountered medical emergency, seen commonly in patients with diabetes who are taking drugs such as insulin or insulin secretagogues (e.g., sulfonylurea) [1]. Management of these cases usually involves parenteral glucose infusion, hypoglycemic dose adjustment, and treatment of underlying precipitating medical conditions. Hypoglycemia can be seen with severe systemic diseases such as sepsis, renal failure, and hepatic failure It has been reported with many medications, including many non-antidiabetic drugs [2]. Our patient felt much improvement, with home sugar readings between 70 and 110 mg/dl and no further symptomatic hypoglycemia
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