Metformin-Induced Hemolytic Anemia

Kirkiz S., Yarali N., Bilir O. A., Tunc B.

MEDICAL PRINCIPLES AND PRACTICE, cilt.23, sa.2, ss.183-185, 2014 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 23 Sayı: 2
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1159/000356149
  • Dergi Adı: MEDICAL PRINCIPLES AND PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.183-185
  • Anahtar Kelimeler: Metformin, Hemolytic anemia, Diabetes mellitus
  • Gazi Üniversitesi Adresli: Hayır

Özet

Objective: To report a rare side effect of metformin, an oral antidiabetic drug that is used for the treatment of type 2 diabetes mellitus. Clinical Presentation and Intervention: A 17-year-old boy was hospitalized for receiving acute lymphoblastic leukemia treatment that was composed of vincristine, L-asparaginase, daunorubicin, and prednisone. Hyperglycemia was determined without any clinical sign and metformin was started for steroid-induced insulin resistance. On the second day of metformin treatment, the patient's hemoglobin level decreased, and a direct Coombs test was positive for immunoglobulin G but negative for complement. An indirect Coombs test was negative. The glucose-6-phosphate dehydrogenase level was within the normal range. Drug-induced hemolytic anemia was suspected and metformin was discontinued. The jaundice gradually disappeared and there was no requirement for red blood cell transfusions. Conclusion: This case showed that physicians should be aware of the potential side effect of metformin although it is infrequent. (C) 2013 S. Karger AG, Basel