Severe hypoglycemic attack exacerbated by carteolol hydrochloride ophthalmic solution in Langerhans cell histiocytosis

Abstract

Beta-blocker eye drops are used to treat ocular hypertension caused by steroids; however, little is known about the risk of hypoglycemia as a side effect. Here, we report the case of a one-year-old girl treated with carteolol hydrochloride ophthalmic solution for ocular hypertension resulting from long-term use of steroids to treat Langerhans cell histiocytosis (LCH). She developed severe hypoglycemia with impaired consciousness and convulsions when she suffered from infectious gastroenteritis. The blocking of the β-receptor by the carteolol hydrochloride ophthalmic solution was considered a major cause of her severe hypoglycemia. β-blockers have a high receptor-binding ability due to their pharmacological properties as receptor blockers. Moreover, their use may lead to side effects regardless of the plasma drug concentration. Therefore, caution is required when prescribing eye drops even at small quantities.