Agranulocytosis due to an α-glucosidase inhibitor, voglibose

Autor: Hiroshi Kaneko, Hidekatsu Yanai, Ruka Hishinuma, Reo Yoshikawa
Rok vydání: 2015
Předmět:
Zdroj: International Journal of Diabetes in Developing Countries. 35:384-385
ISSN: 1998-3832
0973-3930
DOI: 10.1007/s13410-014-0242-7
Popis: Dear Sir, Voglibose, an α-glucosidase inhibitor, lowers the daily glycemic excursions and inhibits overwork of the pancreatic β-cells [1]. Recently, voglibose has been reported to reduce the development of type 2 diabetes in individuals with impaired glucose tolerance (IGT) [2], and now, the use of voglibose for high-risk IGT individuals with dyslipidemia and/or hypertension has been approved by Japanese medical insurance system [2]. Here, we report a case with IGT who showed agranulocytosis due to voglibose. A 55-year-old woman was diagnosed as having hypertension, systemic sclerosis, and pulmonary fibrosis in December 2013, and she has been treated with prednisolone and amlodipine on December 5. Beraprost sodium, pirfenidone, and lansoprazole were started to treat her Raynaud’s phenomenon and pulmonary fibrosis and to prevent peptic ulcer on January 23 and February 15 and 27, 2014, respectively. Pirfenidone was stopped due to liver dysfunction on March 27. Liver dysfunction was ameliorated on April 3; serum aspartate aminotransferase (normal, 13–33 U/l) decreased from 140 U/l (March 27) to 49 U/l (April 3), and serum alanine aminotransferase (normal, 6–27 U/l) decreased from 327 U/l (March 27) to 172 U/l (April 3). She also showed dyslipidemia and IGT; serum levels of low-density lipoprotein cholesterol (184 mg/dl) and triglyceride (210 mg/dl) were elevated, and 2-h post-load plasma glucose concentration (199 mg/ dl) was high. We started to use voglibose (0.6 mg/day) on March 27, and the count of leukocytes and neutrophils were 9,000 and 7,506/μl, respectively, and serum C-reactive protein (CRP) level was 0.07 mg/dl (normal
Databáze: OpenAIRE
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