{
  "abstract": "Single-strength trimethoprim/sulfamethoxazole (TMP/SMX) is standard prophylaxis against Pneumocystis jirovecii pneumonia in solid organ transplant recipients but hypoglycaemia at this prophylactic dose is rare. We report severe recurrent hypoglycaemia after TMP/SMX rechallenge in a man in his 30s who underwent simultaneous kidney-pancreas transplantation. TMP/SMX was withheld because of hyperkalaemia and temporarily replaced with nebulised pentamidine; after the hyperkalaemia resolved, single-strength TMP/SMX (trimethoprim 80 mg/sulfamethoxazole 400 mg once a day) was restarted, at which point renal allograft function and tacrolimus exposure were both stable. Four days later, the patient developed weakness and dizziness with home glucose readings of 28, 33 and 36 mg/dL on consecutive days. Symptoms resolved after drug withdrawal. A Naranjo score of 5 supported a probable TMP/SMX-associated adverse drug reaction, although the absence of paired biochemical testing during the episodes limits definitive mechanistic attribution.",
  "abstract_shown": true,
  "affiliations": [
    "Transplant, Medical City Healthcare, Dallas, Texas, USA",
    "Research, Medical City Dallas Hospital, Dallas, Texas, USA",
    "Medical City Dallas Hospital, Dallas, Texas, USA"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Naseeruddin Khan",
      "orcid": "0009-0005-2392-2264"
    },
    {
      "affs": [
        1
      ],
      "name": "Numair Khan",
      "orcid": "0009-0007-5200-8919"
    },
    {
      "affs": [
        2
      ],
      "name": "Irfan Agha"
    },
    {
      "affs": [
        2
      ],
      "name": "Sareena Contractor"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5yj5w6mvqakxz.bib",
  "cited_by": 0,
  "doi": "10.1136/bcr-2026-275639",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723745/",
  "id": "5yj5w6mvqakxz",
  "issns": [
    "1757-790X"
  ],
  "landing_url": "https://doi.org/10.1136/bcr-2026-275639",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "heading",
      "Clinical Pharmacology"
    ],
    [
      "openalex",
      "2747|Renal Transplantation Outcomes and Treatments"
    ]
  ],
  "openalex": "W7224087774",
  "pdf_url": "https://casereports.bmj.com/content/bmjcr/19/10/e275639.full.pdf",
  "pmcid": "PMC13723745",
  "pmid": "42951318",
  "published": "2026-10-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5yj5w6mvqakxz.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:19Z",
      "native_id": "PMC13723745",
      "source": "pmc",
      "url": "https://doi.org/10.1136/bcr-2026-275639"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2747|Renal Transplantation Outcomes and Treatments",
      "subfield": "surgery"
    }
  ],
  "title": "Single-strength trimethoprim/sulfamethoxazole (TMP/SMX)-induced hypoglycaemia in a post kidney-pancreas transplant patient",
  "title_text": "Single-strength trimethoprim/sulfamethoxazole (TMP/SMX)-induced hypoglycaemia in a post kidney-pancreas transplant patient",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:30Z",
  "url": "https://research.draconitic.com/paper/5yj5w6mvqakxz",
  "venue": "BMJ Case Reports",
  "versions": []
}