ArticleJournal of medical case reports2025
Severe tolvaptan-associated hyperglycemia: a case report.
Article in Journal of medical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTolvaptan-associated hyperglycemia has rarely been described in literature. CASE PRESENTATION: A 95-year-old East Asian (Chinese) male patient with hyponatremia started on tolvaptan treatment at a dosage of 15 mg per day. The patient had a serum sodium concentration of 124.5 mmol/L at baseline; this concentration increased to 138.3 mmol/L over the ensuing 5 months of treatment. Moreover, the patient's fasting blood glucose dramatically increased from 6.3 to 17.2 mmol/L with tolvaptan treatment, and his glycated hemoglobin A1c increased from 5.8% to 9.4%. Tolvaptan was withdrawn owing to hyperglycemia, and insulin pump treatment was started. The serum sodium concentration decreased to 123 mmol/L after tolvaptan withdrawal. The higher levels of blood glucose, insulin, and C-peptide did not return to their previous levels for 5 months after the withdrawal of tolvaptan.
conclusionWe reported a rare case of tolvaptan-associated chronic severe hyperglycemia with a Naranjo probability scale score of 6. Our findings increase clinical knowledge and indicate the need for proactive blood glucose monitoring during prolonged tolvaptan use in clinical practice.
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