Hyperglycemia Induced by Megestrol Acetate in a Patient with AIDS

Abstract

OBJECTIVE:

To report a case of hyperglycemia induced by megestrol acetate in a patient with AIDS.

CASE SUMMARY:

A 28-year-old man with AIDS developed hyperglycemia requiring insulin therapy 5 days after beginning megestrol therapy. The hyperglycemia resolved with discontinuation of the agent and treatment with insulin, and recurred 2 years later, when megestrol acetate treatment was rechallenged. In this case the patient had developed hyperglycemia and pancreatitis 1 year before, related to pentamidine therapy.

DISCUSSION:

To our knowledge this is the first reported case of hyperglycemia that was induced by megestrol acetate as early as 5 days after beginning therapy and confirmed by rechallenge. The mechanism of action is unclear.

CONCLUSIONS:

Clinicians caring for patients with AIDS-related cachexia should be aware that megestrol acetate can cause a severe but reversible hyperglycemic state.