Demirci Ayşe, Bal Oznur, Durnali Ayşe, Ekinci Ahmet Ş, Eşbah Onur, Alkiş Necati, Oksüzoğlu Berna
Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey
Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
J Oncol Pharm Pract. 2014 Dec;20(6):469-72. doi: 10.1177/1078155213508441. Epub 2013 Oct 24.
Sunitinib is an oral inhibitor of tyrosine kinase that was used for the treatment of mRCC. The general side effects are fatigue, asthenia, diarrhea, mucositis, nausea, vomiting, skin changes, hypertension, hypothyroidism and hematologic side effects. In addition, sunitinib-induced hypoglycemia has also been reported. There are limited number of case reports related to sunitinib-induced hypoglycemia.
In this case report, we have presented a patient with type 2 diabetes mellitus (DM) with emerging severe hypoglycemia after sunitinib treatment. It was shown that blood glucose levels were normalized two weeks after the interruption of sunitinib.
Although the underlying mechanism of sunitinib-induced hypoglycemia is not completely understood, sunitinib can be regarded to have an antidiabetic effect. In the literature, there are some reports about sunitinib/other TKI induced hypoglycemia; however, life threatening hypoglycemia is rare. There is no case report of severe hypoglycemia due to imatinib; however, there are two case reports with severe hypoglycemia due to sunitinib treatment. Symptomatic hypoglycemic episodes due to sunitinib may lead to hospital admission. Diabetic patients may develop severe hypoglycaemia and it should be kept in mind that the discontinuation of antihyperglycemic treatment may be required. Therefore, blood glucose levels should be closely monitored in diabetic patients with mRCC during sunitinib therapy.
舒尼替尼是一种口服酪氨酸激酶抑制剂，用于治疗转移性肾细胞癌（mRCC）。其常见副作用包括疲劳、乏力、腹泻、黏膜炎、恶心、呕吐、皮肤改变、高血压、甲状腺功能减退和血液学副作用。此外，也有舒尼替尼诱发低血糖的报道。与舒尼替尼诱发低血糖相关的病例报告数量有限。
在本病例报告中，我们呈现了一名2型糖尿病患者在接受舒尼替尼治疗后出现严重低血糖的情况。结果显示，中断舒尼替尼治疗两周后血糖水平恢复正常。
尽管舒尼替尼诱发低血糖的潜在机制尚未完全明确，但舒尼替尼可被视为具有抗糖尿病作用。在文献中，有一些关于舒尼替尼/其他酪氨酸激酶抑制剂诱发低血糖的报道；然而，危及生命的低血糖情况较为罕见。尚无因伊马替尼导致严重低血糖的病例报告；但有两例因舒尼替尼治疗导致严重低血糖的病例报告。舒尼替尼引起的有症状低血糖发作可能需要住院治疗。糖尿病患者可能会发生严重低血糖，应牢记可能需要停用降糖治疗。因此，在舒尼替尼治疗期间，mRCC糖尿病患者的血糖水平应密切监测。
