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A coproporphyria-like syndrome induced by glipizide
1Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905.
Mayo Clinic Proceedings
|March 1, 1991
Summary
Glipizide, a diabetes medication, can trigger acute attacks of porphyria, a rare metabolic disorder. Discontinuing glipizide resolved the patient's severe abdominal pain and normalized porphyrin levels.
Area of Science:
- Metabolic Disorders
- Clinical Toxicology
- Gastroenterology
Background:
- A 49-year-old male with type II diabetes presented with severe, episodic abdominal pain.
- The patient was recently initiated on glipizide therapy for diabetes management.
- Initial diagnostic workup for abdominal pain was inconclusive.
Observation:
- Episodes of severe abdominal pain were associated with significantly elevated urinary and fecal coproporphyrins.
- Standard treatments for abdominal pain provided no relief.
- Discontinuation of glipizide led to a decrease in coproporphyrin levels.
Findings:
- The case suggests a link between glipizide use and acute attacks of porphyria.
- Elevated coproporphyrin levels indicate a disruption in heme synthesis.
- Resolution of symptoms and normalization of porphyrins post-glipizide cessation confirm the association.
Implications:
- Glipizide should be considered a potential trigger for porphyria attacks.
- This finding expands the list of medications to be avoided in patients with porphyria.
- Clinicians should consider drug-induced porphyria in patients with unexplained abdominal pain and elevated porphyrins.