Rasagiline-induced severe recurrent hypoglycemia in a young woman without diabetes: a case report

BACKGROUND: We report a case of a patient with recurrent severe hypoglycemia after initiating the drug rasagiline (Azilect) for Parkinson disease. CASE PRESENTATION: A 25-year-old Emirati woman who had been diagnosed with Parkinson disease due to a genetic mutation since the age of 18 years presented to our hospital. She had been treated with a rotigotine patch 2 mg per day along with carbidopa + levodopa + entacapone 25 mg/100 mg/200 mg (Stalevo) over these years. Recently, her Stalevo had been changed to rasagiline (a monoamine oxidase B inhibitor). Soon after this change, she started experiencing recurrent documented severe hypoglycemia requiring hospitalization. Her hypoglycemic symptoms completely disappeared after 5–7 days of drug withdrawal. Despite detailed evaluation, no other causal relationship was documented except for rasagiline. CONCLUSIONS: To the best of our knowledge, this case report documents an unknown association between rasagiline and hypoglycemia.