Benign prostatic hyperplasia presenting with profound hypoglycemia: a case report

Abstract

Introduction: Approximately 90% of patients with diabetes have type 2 diabetes. Hypoglycemia is the main side effect of oral antidiabetics, and it can be more serious when it is accompanied by renal failure. Clinical case: We report the case of a man aged 85 years followed for type 2 diabetes and hypertension. He was admitted via the emergency with a disturbed level of consciousness associated with fever. The medical evaluation revealed profound hypoglycemia, obstructive renal failure and an elevated PSA (prostate specific antigen). Oral hypoglycemic agents were discontinued and catheterization was performed resulting in correction of hypoglycemia and renal function. The patient underwent a transurethral resection of prostate (TURP) and pathologic examination was in favor of benign hyperplasia. Neurological disorders related to hypoglycemia were agitation, delirium, impaired higher functions and sleep disorders. However our patient did not present any neurological deficit. The clinical course was favorable. Conclusion: The obstructive renal failure can be a complication of benign prostatic hyperplasia in a final stage. It is responsible for accumulation in the blood of drugs including oral anti-diabetic agents. The resulting hypoglycemia is deleterious to the quality of life of the patient and may be responsible for neurological disorders.

Keywords: Prostate adenoma; Diabetes; severe hypoglycemia; Oral hypoglycemics; Obstructive renal impairment

African Journal of Urology (2013) 19, 44–47