High-dose vitamin-C induced prolonged factitious hyperglycemia in a peritoneal dialysis patient: a case report

Journal of Medical Case Reports

Marie-Hélène Masse¹  François Lamontagne²  Neill K. J. Adhikari³  Olivier Lachance⁴  François Goyer⁵  Jean-François Bilodeau⁶  Marc-André Leclair⁶ 

[1] Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, J1H 5H3, Sherbrooke, QC, Canada;Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue N, J1H 5H3, Sherbrooke, QC, Canada;Department of Medicine, Université de Sherbrooke, 3001 12e Avenue N, J1H 5H3, Sherbrooke, QC, Canada;Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and Interdepartmental Division of Critical Care Medicine, University of Toronto, 2075 Bayview Ave, M4N 3M5, Toronto, ON, Canada;Department of Critical Care Medicine, Université de Montréal, 5400 Boul Gouin Ouest, H4J 1C5, Montreal, QC, Canada;Department of Medical Biochemistry, Université de Sherbrooke, 3001 12e Avenue N, J1H 5H3, Sherbrooke, QC, Canada;Department of Medicine, Université de Sherbrooke, 3001 12e Avenue N, J1H 5H3, Sherbrooke, QC, Canada;

关键词: Ascorbic acid;    Vitamin C;    Intensive care;    Septic shock;    Sepsis;    Peritoneal dialysis;   

DOI  :  10.1186/s13256-021-02869-4

来源: Springer

【 摘 要 】

BackgroundHigh-dose vitamin C is increasingly used for sepsis and more recently for coronavirus disease 2019 (COVID-19) infections. Proponents argue that the low cost and near perfect safety profile of vitamin C support its early adoption. Yet, adverse events might be underreported and underappreciated.Case presentationWe report a 73-year-old non-diabetic white man with end-stage renal disease on peritoneal dialysis admitted to the intensive care unit with septic shock that was suspected to be due to peritonitis. The patient was enrolled in LOVIT (Lessening Organ Dysfunction with VITamin C; ClinicalTrials.gov identifier: NCT03680274), a randomized placebo-controlled trial of high-dose intravenous vitamin C. He developed factitious hyperglycemia, as measured with a point-of-care glucometer, that persisted for 6 days after discontinuation of the study drug, confirmed to be vitamin C after unblinding. He also had short-lived iatrogenic coma because of hypoglycemia secondary to insulin administration. These events triggered a protocol amendment.ConclusionsAlthough factitious hyperglycemia has been reported before using certain glucometers in patients treated with high-dose vitamin C, the persistence of this phenomenon for 6 days after the discontinuation of the therapy is a distinguishing feature. This case highlights the importance of monitoring glucose with a core laboratory assay for up to a week in specific populations, such as patients on peritoneal dialysis.

【 授权许可】

CC BY