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Metformin-Induced Hemolysis in a Patient With Glucose-6-Phosphate Dehydrogenase Deficiency Presenting With Concurrent Idiopathic Steven-Johnson Syndrome/Toxic Epidermal Necrolysis

Roy Choudhury A, Gadaga C, Moodley L, Moodley A

Cureus, 2021

Abstract

Metformin is one of the most widely prescribed medications for type 2 diabetes. While extremely rare, metformin has been reported to cause hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency. In this paper, we present a case of a patient with previously undiagnosed glucose-6-phosphate dehydrogenase deficiency who presented with hemolysis likely induced by metformin. The patient concurrently presented with idiopathic Steven-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Metformin causing hemolysis is extremely rare but considering the severe outcomes, it is something that medical practitioners need to be aware of.

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