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Acute, life-threatening hypoglycemia associated with haloperidol in a hematopoietic stem cell transplant recipient

Bone Marrow Transplantation volume 37, pages 109–110 (2006)Cite this article

Neuroleptics are considered the mainstay for symptomatic treatment of delirium, and haloperidol is frequently the preferred drug because it is less sedating than phenothiazines and has a low incidence of anticholinergic, hypotensive, respiratory, and cardiotoxic side effects.1 Well-characterized adverse events of haloperidol and other antipsychotics include extrapyramidal effects and neuroleptic malignant syndrome. Here, we present the case of a hematopoietic stem cell transplant (SCT) patient with acute, severe, life-threatening hypoglycemia associated with haloperidol. To our knowledge, this is only the second report in the literature describing a severe hypoglycemic reaction with haloperidol.2

This African-American male was diagnosed with chronic lymphocytic leukemia (CLL) at age 47 years. Over the next 6 years, he was treated with multiple rounds of chemotherapy and/or monoclonal antibodies. At age 53 years, the patient received nonmyeloablative conditioning with fludarabine (total of 90 mg/m2) and total body irradiation (200 cG) followed by an HLA-matched unrelated donor peripheral blood SCT (22.06 × 106 CD34+ cells/kg). His prior medical history was also remarkable for chronic hepatitis C (genotype 1A) that failed eradication therapy with interferon and ribavirin, and liver biopsy at the time of transplant revealed chronic hepatitis with minimal activity and portal to periportal fibrosis, consistent with hepatitis C-induced disease (grade 1, stages 1 and 2; Batts and Ludwig3). There was no history of an endocrine disorder.

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Authors and Affiliations

  1. Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    R B Walter & S J Collins

  2. Department of Laboratory Medicine, University of Washington, Seattle, WA, USA

    A N Hoofnagle

  3. Seattle Cancer Care Alliance, Seattle, WA, USA

    S A Lanum

  4. Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    S J Collins

Authors
  1. R B Walter
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  2. A N Hoofnagle
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  3. S A Lanum
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  4. S J Collins
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Correspondence to R B Walter.

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Walter, R., Hoofnagle, A., Lanum, S. et al. Acute, life-threatening hypoglycemia associated with haloperidol in a hematopoietic stem cell transplant recipient. Bone Marrow Transplant 37, 109–110 (2006). https://doi.org/10.1038/sj.bmt.1705187

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