Hydroxychloroquine-Induced Hypoglycemia in a Patient Without Diabetes

Area of Science:

• Rheumatology
• Endocrinology
• Pharmacology

Background:

• Hydroxychloroquine is a disease-modifying antirheumatic drug (DMARD) used for autoimmune conditions.
• Hypoglycemia is a rare but documented adverse effect of hydroxychloroquine, potentially linked to altered insulin metabolism.
• Existing literature lacks detailed follow-up on the duration and resolution of hydroxychloroquine-induced hypoglycemia.

Observation:

• A 55-year-old female experienced recurrent hypoglycemic episodes with fasting blood glucose levels between 60-70 mg/dL.
• The patient reported consistent hypoglycemic symptoms.
• Improvement in symptoms and glucose levels was observed three months after discontinuing hydroxychloroquine.

Findings:

• Hydroxychloroquine was identified as the probable cause of hypoglycemia using the Naranjo scale.
• The resolution of hypoglycemia following drug cessation supports the causal link.
• The patient's recovery indicates a prolonged resolution period, consistent with hydroxychloroquine's long half-life.

Implications:

• Clinicians should consider hydroxychloroquine as a potential cause of hypoglycemia in patients presenting with related symptoms.
• Awareness of this adverse effect is crucial for patient safety, especially given the extended time for resolution.
• Further research into the mechanisms and management of hydroxychloroquine-induced hypoglycemia is warranted.