Sulfonylurea-induch hypoglycemia in 33 diabetics.

We analyzed 33 diabetic patients (12 males and 21 females) receiving sulfonylurea drug who were hospitalized for severe hypoglycemia during the period 1980-1991. Most patients (46%) had diabetes for 1-5 years and were aged between 50 and 59 years. There were associated hypertension (65%), cataract (55%), retinopathy (50%) and renal failure (45%). Sixty-one percent of them had received glibenclamide, 36 percent were on chlorpropamide and 3 percent on glipizide. Seven of them (21%) died. Among those survived, there were neither sequelae nor disability. Patients who were comatose on admission were likely to die. We suggest that sulfonylurea should be avoided or used carefully in elderly diabetic patients having renal impairment because of the potential risk of hypoglycemia which might be fatal.

Sertoli-cell-only syndrome: a case report.

A 20-year-old male presented with a small hydrocoele in the left scrotal sac, bilateral small testes, and azoospermia with normal secondary sexual characteristics. Chromosome study revealed 46,XY. The results of hormonal and histopathological studies were consistent with Sertoli-cell-only syndrome.

Complete heart block complicating hyperthyroidism: a case report.

Complete heart block developed in a 29-year-old man with hyperthyroidism and acute febrile illness. The definite cause of acute febrile illness was unknown. The results of bacteriological and viral studies were negative. Endomyocardial biopsy revealed no evidence of carditis which is the common cause of heart block. All the abnormalities resolved completely after the fever subsided and the patient was treated with an antithyroid drug. Available information indicates that a high degree of heart block can sometimes occur in hyperthyroidism in either the presence or absence of additional factors which can independently impair atrioventricular conduction. This course of events which occurred in this patient suggest that complete heartblock may have been the direct manifestation of the hyperthyroid state, however, the acute febrile illness may have been an aggravating factor in the development of abnormal atrioventricular conduction.