Kamei Shinji, Kaneto Hideaki, Tanabe Akihito, Irie Shintaro, Hirata Yurie, Shimoda Masashi, Kohara Kenji, Mune Tomoatsu, Kaku Kohei
Division of Diabetes, Metabolism and Endocrinology, Kawasaki Medical School Kurashiki, Japan.
J Diabetes Investig. 2015 May;6(3):343-5. doi: 10.1111/jdi.12301. Epub 2014 Dec 29.
Diabetic neuropathy is the most common diabetic complication. Duloxetine, a serotonin noradrenaline reuptake inhibitor (SNRI), is widely used for the treatment of diabetic painful neuropathy (DPN) because of the efficacy and safety profile. Syndrome of inappropriate antidiuretic hormone secretion, which is strongly associated duloxetine, is a rare but occasionally life-threatening adverse effect. Here, we report a case of syndrome of inappropriate antidiuretic hormone secretion that rapidly developed after starting duloxetine in an elderly Japanese female type 2 diabetes mellitus patient. Furthermore, we discuss the possible relationship between the onset of syndrome of inappropriate antidiuretic hormone secretion and the gene polymorphism of cytochrome P450 isoform 1A2 and 2D6, both of which are responsible for duloxetine metabolism.
糖尿病神经病变是最常见的糖尿病并发症。度洛西汀是一种5-羟色胺去甲肾上腺素再摄取抑制剂（SNRI），因其疗效和安全性而被广泛用于治疗糖尿病性疼痛性神经病变（DPN）。与度洛西汀密切相关的抗利尿激素分泌异常综合征是一种罕见但偶尔会危及生命的不良反应。在此，我们报告一例老年日本2型糖尿病女性患者在开始使用度洛西汀后迅速发生抗利尿激素分泌异常综合征的病例。此外，我们还讨论了抗利尿激素分泌异常综合征的发病与细胞色素P450同工酶1A2和2D6基因多态性之间的可能关系，这两种同工酶均参与度洛西汀的代谢。
