• Internal medicine · Jul 2021

    Cholinergic Crisis Owing to Distigmine Bromide Complicated by Hyperosmolar Hyperglycemic State.

    • Kazumasa Kotake, Atsuhito Tone, Satoko Watanabe, Mayumi Senoo, Mitsuhiro Kaneto, Yusuke Imai, Sanae Teshigawara, Yasuhiro Kawakami, and Tatsuaki Nakatou.
    • Department of Pharmacy, Okayama Saiseikai General Hospital, Japan.
    • Intern. Med. 2021 Jul 15; 60 (14): 2251-2254.

    AbstractDistigmine bromide is widely used to treat neurogenic bladder and causes cholinergic crisis, a serious side effect. We herein report about a patient with distigmine bromide-induced cholinergic crisis complicated by a hyperosmolar hyperglycemic state (HHS). On admission, the patient was diagnosed with HHS based on the medical history and laboratory test results. However, she also had bradycardia, miosis, and low plasma cholinesterase activity. We later found that she had received distigmine bromide, which led to a diagnosis of cholinergic crisis. We suggest that the exacerbation of pathology, including HHS, can cause cholinergic crisis in patients receiving distigmine bromide.

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