Voluntary self-poisoning with metformin and antiretroviral therapy drugs
Abstract
Metformin is the first-line oral drug prescribed in type 2 diabetes. The main severe side effect of this drug is metformin associated lactic acidosis (MALA), which generally occurs accidentally and rarely in patients with renal failure. We present here a case of voluntary self-poisoning with metformin and antiretroviral therapy drugs. On admission, the patient showed lactic acidosis with a pH of 7.19 (normal ranges: 7.38-7.42) and lactates at 9.40 mmol/L (normal ranges: 0.50-2.20 mmol/L). Metformin and antiretroviral therapy intoxication was confirmed by detecting these drugs with high performance liquid chromatography coupled with diode array detector (HPLC-PDA) and a another HPLC with mass spectrometry (HPLC-MS) then by a metformin dosage at 814 mg/L (therapeutic ranges: 1-2 mg/L). During hospitalization, liver dysfunctionned, contributing to an altered lactate elimination. Therefore, lactic acidosis increased as the patient's state worsened. Therapeutics were inefficient, leading to patient's death 30 hours after presentation. This observation illustrates a rare case of voluntary intoxication with a high dose of metformin and its unusual association with antiretroviral therapy drugs, that could increase lactic acidosis and cause liver failure.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.