Fluoxetine induced Hypoglycaemia in a patient with persistent form of Congenital Hyperinsulinism (CHI) on Lanreotide Therapy.

We report a patient with persistent congenital hyperinsulinism (CHI) who developed recurrent hypoglycaemia following Fluoxetine therapy. A 15-year-old girl with persistent CHI was initially managed with diazoxide therapy. She developed troublesome hypertrichosis, which affected her quality of life adversely. Diazoxide was then slowly weaned and stopped with the introduction of Octreotide, to which she responded well. Subcutaneous Lanreotide (long acting somatostatin analogue) was subsequently commenced (30mg, once monthly) as injecting Octreotide multiple times a day was proving to be difficult for the patient. The continuous blood glucose monitoring on monthly Lanreotide injections revealed good glycaemic control. Six months later, she developed depression due to psychosocial problems at school. She was commenced on Fluoxetine by the psychiatry team. She subsequently developed recurrent symptomatic hypoglycaemic episodes (blood glucose <3.5mmol/l) and hence Fluoxetine was discontinued, following which the hypoglycaemic episodes resolved within a week. Fluoxetine has been associated with hypoglycaemia in patients with diabetes mellitus. We report, for the first time, hypoglycaemia secondary to Fluoxetine in a patient with CHI. PMID: 27087264 [PubMed - as supplied by publisher]
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Tags: J Clin Res Pediatr Endocrinol Source Type: research