Document 0106
 DOCN  M9590106
 TI    Mefloquine-associated hypoglycaemia in a cachectic AIDS patient.
 DT    9509
 AU    Assan R; Perronne C; Chotard L; Larger E; Vilde JL; Diabetes Dpt.,
       Hopital Bichat, Paris, France.
 SO    Diabete Metab. 1995 Feb;21(1):54-8. Unique Identifier : AIDSLINE
       MED/95301041
 AB    Quinine and its isomer quinidine are well-known causes of iatrogenic
       hypoglycaemia, due to excessive insulin secretion. The situation is less
       clear regarding other anti-malarial quinine analogues. In particular,
       this adverse effect has never been described with mefloquine (Lariam).
       We report a case of hypoglycaemia after mefloquine therapy (1,500 mg
       over two days) for severe gastrointestinal cryptosporidiasis in a
       cachectic AIDS patient with protracted diarrhoea. Blood glucose levels,
       which were normal before treatment, dropped to 2.3 mmol/l within a few
       hours and were corrected by i.v. glucose infusion. Hypoglycaemia did not
       recur despite continued treatment. Rat islets of Langerhans exposed to
       mefloquine in vitro (10(-8) mol/l to 10(-3) mol/l) secreted
       significantly more insulin than control islets (up to 980 +/- 180
       microU/ml/5 islets incubated with mefloquine 10(-3) mol/l, vs 20 +/- 4
       microU/ml/5 untreated islets). Mechanisms and triggering factors of
       hypoglycaemia induced by mefloquine and some other anti-malarial quinine
       analogues are discussed. Clinicians who manage cachectic patients,
       particularly those with protracted diarrhoea and/or receiving
       anti-malarial drugs including mefloquine, should be aware of the risk of
       severe hypoglycaemia.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult
       Cachexia/*ETIOLOGY  Case Report  Cryptosporidiosis/COMPLICATIONS/*DRUG
       THERAPY  Human  Hypoglycemia/*CHEMICALLY INDUCED  Male
       Mefloquine/*ADVERSE EFFECTS  JOURNAL ARTICLE

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