HYPERGLYCEMIA-INDUCED BY MEGESTROL-ACETATE IN A PATIENT WITH AIDS

OBJECTIVE: To report a case of hyperglycemia induced by megestrol acet ate in a patient with AIDS, CASE SUMMARY: A 28-year-old man with AIDS developed hyperglycemia requiring insulin therapy 5 days after beginni ng megestrol therapy. The hyperglycemia resolved with discontinuation of the agent and treatment with insulin, and recurred 2 years later, w hen megestrol acetate treatment was rechallenged. In this case the pat ient had developed hyperglycemia and pancreatitis 1 year before, relat ed to pentamidine therapy, DISCUSSION: To our knowledge this is the fi rst reported case of hyperglycemia that was induced by megestrol aceta te as early as 5 days after beginning therapy and confirmed by rechall enge. The mechanism of action is unclear. CONCLUSIONS: Clinicians cari ng for patients with AIDS-related cachexia should be aware that megest rol acetate can cause a severe but reversible hyperglycemic state.