Ritonavir
- PDF / 170,064 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 19 Downloads / 140 Views
1 S
Hyperglycemic hyperosmolar syndrome: case report A 59-year-old man developed hyperglycaemic hyperosmolar syndrome (HHS) during treatment with ritonavir for HIV infection. The pre-diabetic man presented with fatigue and some nausea for the past 3 days. Subsequent laboratory tests showed increased blood sugar (1900 mg/dL), increased HbA1c (19%), serum bicarbonate 22 [unit not stated], blood pH 7.38, serum osmolarity 340 mmol/kg, and negative serum acetone and negative urine ketones. Based on these findings, a diagnosis of HHS was made. The man was therefore admitted to a Medical ICU in USA, and was treated with IV fluids and IV insulin. After normalisation of the blood sugar levels, he was shifted to the medical floor and was given diabetic education. Upon anamnesis, it was revealed that, six weeks prior to the current presentation, he had been diagnosed with HIV, and had started receiving highly active antiretroviral therapy (HAART) containing ritonavir [dosage and route not stated] along with other unspecified HIV drugs in combination. Additionally, a review of his previous blood test records (performed 8 weeks prior) showed blood sugar of 115 mg/dL and HbA1C of 6.2% (baseline). Based on the clinical presentation, and based upon the temporal relation between ritonavir and a sudden increase in the blood sugar level and increased HbA1c, a diagnosis of ritonavir-related HHS was determined [duration of treatment to reaction onset not stated]. Ritonavir was therefore stopped, and his HIV regimen was changed to another regimen. He was then discharged on new HAART regimen along with SC insulin. He was followed up closely on outpatient department for further 3 months. His blood sugar and HbA1C levels were found to be returned to the baseline and insulin was then discontinued. Thereafter, he was managed without use of any anti-diabetic medication. Kumar V, et al. HAART-induced Hyperglycemic hyperosmolar syndrome (A Rare manifestation of HAART therapy). Journal of Diabetes Science and Technology 13: 61, No. 2, Mar 2019 [abstract] 803516018
0114-9954/20/1831-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 21 Nov 2020 No. 1831
Data Loading...
