Severe Hypoglycemia

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Abstract
MOST reported side effects of chlorpropamide are transient and dose-related. Occasionally, severe toxicity involving the liver, skin, bone marrow, and gastrointestinal tract occurs.1 Hypoglycemic complaints are usually minor, and coma is rare if the drug is given in recommended doses. However, since chlorpropamide is excreted unchanged by the kidney, renal failure might be expected to cause abnormal retention with subsequent prolonged hypoglycemia. The purpose of this report is to describe a case of severe, recurrent hypoglycemic coma due to failure of excretion of chlorpropamide as a result of glomerulonephritis. It emphasizes the need for careful observation of renal function in diabetics on chlorpropamide therapy and stresses the importance of considering iatrogenic factors in the etiology of hypoglycemic coma. Report of Case A 43-year-old male was admitted to the Newark Beth Israel Hospital on April 20, 1963, in a comatose state. His wife stated that he had been in excellent

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