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Two additional cases of metformin‐associated encephalopathy in patients with end‐stage renal disease undergoing hemodialysis
Author(s) -
Kang YeoJin,
Bae Eun Jin,
Seo Jong Woo,
Jeon DaeHong,
Cho Hyun Seop,
Kim HyunJung,
Chang SeHo,
Park Dong Jun
Publication year - 2013
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2012.00698.x
Subject(s) - medicine , metformin , hemodialysis , encephalopathy , magnetic resonance imaging , end stage renal disease , diabetes mellitus , kidney disease , disease , stage (stratigraphy) , diabetic nephropathy , gastroenterology , surgery , radiology , endocrinology , paleontology , biology
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 T 2‐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 T 2‐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.