2019 Volume 62 Issue 12 Pages 769-773
A 52-year-old man was treated with steroids for Kimura's disease and chemotherapy for relapsed lung cancer. In November X, he was admitted with a fever and dyspnea and diagnosed with pneumocystis pneumonia. He was initially given steroids and sulfamethoxazole-trimethoprim, but the treatment was changed to pentamidine due to side effects of sulfamethoxazole-trimethoprim on day 10. Seven days after starting pentamidine, he experienced fasting hypoglycemia and was given dextrose (10 g). We suspected pentamidine-induced hypoglycemia, and he had recurrent nocturnal hypoglycemia for 10 days after the cessation of pentamidine. The use of a continuous glucose monitoring system helped avoid nocturnal hypoglycemia in this patient. Pentamidine has rarely been reported to induce hypoglycemia. Drug-induced hypoglycemia is a significant adverse effect and may be an important cause of morbidity. This case is the first to demonstrate the value of continuous glucose monitoring for the detection of pentamidine-induced nocturnal hypoglycemia.
