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Ceftriaxone-associated Biliary Pseudolithiasis with Elderly Type 1 Diabetes Mellitus: Two Case Reports
Ken Kanazawa1, Shogo Suzuki1, Tatsuro Inaba1
1Departments of Diabetes, Metabolism and Endocrinology, Japan Labor Health and Safety Organization, Tokyo Rosai Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|April 9, 2023
Summary
Ceftriaxone (CTRX) can cause biliary pseudolithiasis, particularly in elderly patients with type 1 diabetes mellitus (T1DM). Caution is advised when prescribing CTRX to this vulnerable population, especially those with diabetic autonomic neuropathy.
Area of Science:
- Pharmacology
- Endocrinology
- Gastroenterology
Background:
- Biliary pseudolithiasis is a known complication of ceftriaxone (CTRX) treatment.
- The specific risk in elderly patients with type 1 diabetes mellitus (T1DM) remains unclear.
- Diabetic autonomic neuropathy is a common comorbidity in elderly T1DM patients.
Observation:
- Two elderly female patients with T1DM presented with conditions requiring CTRX treatment.
- Case 1: A 78-year-old with T1DM and diabetic autonomic neuropathy developed biliary pseudolithiasis and cholecystitis on day 8 of CTRX therapy.
- Case 2: An 80-year-old with T1DM developed asymptomatic biliary pseudolithiasis and gastroparesis after a week of CTRX treatment.
Findings:
- Ceftriaxone (CTRX) administration was associated with the development of biliary pseudolithiasis in both elderly T1DM patients.
- The findings suggest a potential link between CTRX use and biliary pseudolithiasis in this specific demographic.
- Diabetic autonomic neuropathy may be a contributing factor or indicator of increased risk.
Implications:
- Ceftriaxone (CTRX) should be used with caution in elderly patients with type 1 diabetes mellitus (T1DM).
- Particular vigilance is recommended for T1DM patients who also have diabetic autonomic neuropathy.
- Further research is warranted to elucidate the mechanisms and confirm the risk in this population.
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