SEVERE CHLORPROPAMIDE TOXICITY

Abstract

Chlorpropamide (Diabinese) is a potent, orally used, hypoglycemic sulfonylurea derivative that recently has been used in the management of diabetes mellitus. Earlier reports¹of clinical trials have, in general, mentioned only minimal sideeffects or none at all when the drug is used in recommended therapeutic doses. Probably the most common complaints have been referable to hypoglycemia and consist of weakness, giddiness, and paresthesias.²Minor gastrointestinal symptoms have also been reported.³Observed hematological changes include thrombocytopenia,⁴granulocytopenia,⁵erythrocytic stippling,^2aand eosinophilia.⁶Various skin lesions have been described, including maculopapular eruptions,⁷urticaria,⁸exfoliative dermatitis,⁹erythema multiforme,^2aand purpura.⁴Obstructive jaundice has been mentioned in isolated reports.¹⁰Liver biopsy specimens in these cases have been characterized mainly by cholestasis.¹¹Other less commonly noted toxic effects have been crystalluria,^2amuscular weakness,^3bdecrease in thyroid function,^2cand a