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Metformin-Associated Encephalopathy as a Rare but Serious Adverse Effect: A Case Report
Anna Aoki1, Daisuke Mizu1, Hidenori Higashi1
1Department of Emergency Medicine, Japanese Red Cross Osaka Hospital, Osaka, JPN.
Cureus
|February 19, 2026
Resumen
Metformin-associated encephalopathy is a rare complication of type 2 diabetes treatment, especially in patients with kidney problems. Prompt diagnosis and treatment, including discontinuing metformin and initiating hemodialysis, can lead to rapid recovery.
Área de la Ciencia:
- Nefrología
- Neurología
- Farmacología
Sus antecedentes:
- La metformina es un tratamiento de primera línea común para la diabetes tipo 2.
- La encefalopatía asociada a metformina es un efecto adverso raro pero grave.
- La insuficiencia renal aumenta el riesgo de esta afección.
Objetivo del estudio:
- Presentar un caso de encefalopatía asociada a metformina en un paciente en hemodiálisis.
- Destacar las características clínicas y de imagen de esta afección.
- Enfatizar la importancia de la prescripción cuidadosa de metformina en pacientes con insuficiencia renal.
Principales métodos:
- Informe de caso de una mujer de 44 años con nefropatía diabética en hemodiálisis.
- La presentación clínica incluyó disartria, debilidad generalizada, alteración de la marcha, acidosis metabólica e hiperlactatemia.
- La resonancia magnética cerebral reveló hiperintensidad bilateral de los ganglios basales.
Principales resultados:
- Los síntomas y los hallazgos de la resonancia magnética del paciente mejoraron rápidamente después de la interrupción de la metformina y la hemodiálisis de emergencia.
- Se confirmó el diagnóstico de encefalopatía asociada a metformina.
- Este caso subraya el potencial de complicaciones neurológicas graves por el uso inadecuado de metformina.
Conclusiones:
- La encefalopatía asociada a metformina es un efecto adverso grave que puede ocurrir con una prescripción inadecuada en caso de insuficiencia renal.
- Los médicos de urgencias deben estar alerta a esta afección.
- El reconocimiento y manejo tempranos, incluida la hemodiálisis, son cruciales para la recuperación del paciente.
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