October - December 2018, Volume 14, Issue 4

Iliescu L, Mercan-Stanciu A, Toma L, Ioanitescu ES

A Severe Case of Hyperglycemia in a Kidney Transplant Recipient Undergoing Interferon-Free Therapy for Chronic Hepatitis C

Acta Endo (Buc) 2018, 14 (4): 533-538
doi: 10.4183/aeb.2018.533

Context. Hepatitis C and diabetes represent important health problems globally. The new-onset diabetes after transplantation is a particular entity that appears due to the use of immunosuppression among transplanted patients. Objective. We aim to describe the clinical and biological aspects of severe hyperglycemia in a kidney transplant recipient undergoing Interferon-free therapy for chronic hepatitis C, discussing the interference of different factors with the glucose metabolism. Design. The occurrence of diabetes in a patient with history of renal transplantation and Interferon-free treated hepatitis C was studied from both clinical and paraclinical points of view. Subjects and methods. When presenting to the hospital, extensive blood tests were performed on the patient, revealing significant hyperglycemia and an elevated level of blood tacrolimus. Creatinine clearance was calculated. ECG presented T-wave alterations. Intensive insulin protocol was applied, the case being managed in a multidisciplinary approach. Results. Blood glucose and tacrolimus were slowly normalized, under therapy. The antiviral treatment was continued, with the achievement of sustained virologic response. Conclusions. Diabetes mellitus can have many causes, hepatitis C and transplantation both having an impact on glucose metabolism. The association of the three entities should be carefully managed, due to its enhancing effect on morbidity and mortality.

Keywords: chronic hepatitis C, kidney transplant, diabetes mellitus, Paritaprevir, Ombitasvir, Dasabuvir.

Correspondence: Laura Iliescu MD, Fundeni Clinical Institute, Dept. of Internal Medicine, 258 Fundeni Road, 2nd District, Bucharest, 022328, Romania, E-mail: laura_ate@yahoo.com