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.