We present a patient with type 2 diabetes mellitus and metastatic renal cell carcinoma who developed severe hypoglycemia and metabolic encephalopathy after sunitinib treatment. Sunitinib, a multi-target tyrosine kinase inhibitor, is used to treat metastatic renal cell carcinoma. Sunitinib-induced hypoglycemia has been reported and there are rare case reports of severe hypoglycemia due to sunitinib. Therefore, glycemic control should be monitored closely in diabetic patients treated with sunitinib.
Many drugs have been known to induce lupus-like syndrome, composing approximately 10% of all SLE cases. Isoniazid-induced lupus erythematosus affects either sex equally and the most common presenting feature is arthralgia or arthritis with anemia. Fever and pleuritis occur in approximately half of the cases, and pericarditis in approximately 30% of cases. We discribe a 28-year-old woman receiving antituberculous medications including isoniazid for one month. She was hospitalized with fever, arthralgia and newly developed pleural effusion The analysis of pleural fluid and serum revealed an elevated level of antinuclear antibody. We suspected of drug induced lupus and stopped isoniazid medication. After discontinuation of isoniazid and short course of prednisolone treatment, her symptoms and pleural effusion disappeared. This case is to our knowledge, the fist report of isoniazid induced SLE in Korea.
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