Haemolytic anaemia due to metformin

Kashyap, A S; Kashyap, Surekha

doi:10.1136/pmj.76.892.125

Cited by 29 publications

(22 citation statements)

References 2 publications

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“…The possible mechanism of metformin-induced hemolytic anemia discussed here is different from that proposed by Kashyap and Kashyap in their report [ 2 ]. Their patient's DAT was positive for anti-C3 and negative for anti-IgG, which suggests the formation of an antibody against the erythrocyte-drug complex.…”

Section: Discussioncontrasting

confidence: 92%

Fatal hemolytic anemia associated with metformin: A case report

2008

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Section: Discussioncontrasting

confidence: 92%

Fatal hemolytic anemia associated with metformin: A case report

2008

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“…Other adverse reactions are sporadic, such as leucocytoclastic vasculitis, allergic pneumonitis [170], cholestatic jaundice [171], and hemolytic anaemia [172]. …”

Section: Introductionmentioning

confidence: 99%

Metformin: an old but still the best treatment for type 2 diabetes

Rojas

Gomes

2013

Diabetol Metab Syndr

479

348

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The management of T2DM requires aggressive treatment to achieve glycemic and cardiovascular risk factor goals. In this setting, metformin, an old and widely accepted first line agent, stands out not only for its antihyperglycemic properties but also for its effects beyond glycemic control such as improvements in endothelial dysfunction, hemostasis and oxidative stress, insulin resistance, lipid profiles, and fat redistribution. These properties may have contributed to the decrease of adverse cardiovascular outcomes otherwise not attributable to metformin’s mere antihyperglycemic effects. Several other classes of oral antidiabetic agents have been recently launched, introducing the need to evaluate the role of metformin as initial therapy and in combination with these newer drugs. There is increasing evidence from in vivo and in vitro studies supporting its anti-proliferative role in cancer and possibly a neuroprotective effect. Metformin’s negligible risk of hypoglycemia in monotherapy and few drug interactions of clinical relevance give this drug a high safety profile. The tolerability of metformin may be improved by using an appropiate dose titration, starting with low doses, so that side-effects can be minimized or by switching to an extended release form. We reviewed the role of metformin in the treatment of patients with type 2 diabetes and describe the additional benefits beyond its glycemic effect. We also discuss its potential role for a variety of insulin resistant and pre-diabetic states, obesity, metabolic abnormalities associated with HIV disease, gestational diabetes, cancer, and neuroprotection.

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“…A few cases with metformin-induced hemolysis had been reported and all cases have been in adults [ 2 , 6 , 7 , 8 , 9 ], but in this study it occurred in a teenager. Death was reported in only 1 case; the other cases recovered after discontinuation of the drug [ 6 ], as in our case.…”

Section: Discussionmentioning

confidence: 57%

“…The most common adverse effects of this drug are diarrhea, dyspepsia, poor appetite, vomiting, lactic acidosis, and metallic taste. Long-term use of metformin substantially increases the risk of vitamin B 12 deficiency; however, its clinical significance is not known [ 2 ]. We report a patient with acute lymphoblastic leukemia (ALL) who developed hemolytic anemia due to metformin therapy.…”

Section: Introductionmentioning

confidence: 99%

Metformin-Induced Hemolytic Anemia

et al. 2013

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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.

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Haemolytic anaemia due to metformin

Cited by 29 publications

References 2 publications

Fatal hemolytic anemia associated with metformin: A case report

Fatal hemolytic anemia associated with metformin: A case report

Metformin: an old but still the best treatment for type 2 diabetes

Metformin-Induced Hemolytic Anemia

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