Arem R, Garber A J, Field J B
Arch Intern Med. 1983 Apr;143(4):827-9.
Severe hypoglycemia with an inappropriately elevated insulin level occurred in a patient with chronic renal failure who was taking two tablets of sulfamethoxazole and trimethoprim twice a day for a urinary tract infection. Hypoglycemia was readily corrected with intravenous glucose and did not recur after discontinuation of the sulfonamide. Insulin and glucose determinations during a 48-hour fast while the patient was rechallenged with this compound, as compared with those obtained during a 72-hour fast performed 12 days after discontinuation of the therapy, suggest that the hypoglycemic episode was related to hyperinsulinemia probably induced by the sulfonamide. Other factors, including congestive heart failure, growth hormone deficiency, and hypoalaninemia might have contributed to the development of hypoglycemia in this patient.
一名患有慢性肾衰竭的患者因尿路感染每天服用两片磺胺甲恶唑和甲氧苄啶，出现了严重低血糖且胰岛素水平异常升高。静脉输注葡萄糖后低血糖迅速得到纠正，停用磺胺类药物后未再复发。在患者再次使用该复方药物期间进行的48小时禁食期间测定的胰岛素和葡萄糖水平，与停药12天后进行的72小时禁食期间所测结果相比，提示低血糖发作可能与磺胺类药物诱导的高胰岛素血症有关。其他因素，包括充血性心力衰竭、生长激素缺乏和低丙氨酸血症，可能也促使了该患者低血糖的发生。
