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Two additional cases of metformin‐associated encephalopathy in patients with end‐stage renal disease undergoing hemodialysis |
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| Authors: | Yeo‐Jin Kang Eun Jin Bae Jong Woo Seo Dae‐Hong Jeon Hyun Seop Cho Hyun‐Jung Kim Se‐Ho Chang Dong Jun Park |
| Affiliation: | 1. Department of Internal Medicine, School of Medicine Gyeongsang National University, , Jinju City, Gyeongsangnam‐do, South Korea;2. Institute of Health Science, School of Medicine Gyeongsang National University, , Jinju City, Gyeongsangnam‐do, South Korea |
| Abstract: | We report on two additional cases of metformin‐associated encephalopathy in patients with end‐stage renal disease (ESRD) undergoing hemodialysis. Two patients were seen at our hospital with abnormal neurological signs and symptoms. Magnetic resonance imaging (MRI) revealed the same pattern of high signal intensity in both basal ganglia in T2‐weighted images in the two patients. The two patients had started taking metformin 5 and 6 weeks earlier at the same dose of 1000 mg per day. Metformin was immediately stopped, and regular hemodialysis was conducted. Their signs and symptoms resolved completely after these measures. The high signal intensity in both ganglia in T2‐weighted MRI also disappeared. We should suspect metformin‐induced encephalopathy and withdraw the drug when presented with diabetic patients with chronic kidney disease and neurological signs and symptoms of unknown cause. |
| Keywords: | metformin encephalopathy intoxication chronic kidney disease hemodialysis |