Linperlisib causing high blood sugar and hyponatremia, leading to facial nerve paralysis and muscle nerve damage: A rare case report

• Published in: Medicine (Baltimore) Vol. 104; no. 24; p. e42875
• Main Authors: Jiang, Yu-cai, Zhao, Cheng-fei, Zheng, Lin-lin
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 13.06.2025
• Subjects: Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Blood Glucose; Class I Phosphatidylinositol 3-Kinases - antagonists & inhibitors; Clinical Case Report; Enzyme Inhibitors - adverse effects; Enzyme Inhibitors - therapeutic use; Facial Nerve Diseases - chemically induced; Facial Paralysis - chemically induced; Facial Paralysis - diagnosis; Humans; Hyperglycemia - chemically induced; Hyperglycemia - diagnosis; Hyponatremia - chemically induced; Hyponatremia - diagnosis; Lymphoma, T-Cell, Peripheral - drug therapy; Male; Middle Aged; facial palsy; hyperglycemia; myalgia; linperlisib; hyponatremia
• ISSN: 1536-5964; 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000042875

Rationale: Linperlisib is a highly selective small-molecule inhibitor of phosphatidylinositol-3-kinase delta for the treatment of relapsed/refractory follicular lymphoma. Patient concerns: The patient was a 64-year-old male with peripheral T-cell lymphoma and diabetes mellitus who experienced hyperglycemia, hyponatremia, facial palsy, and myalgia during linperlisib treatment. Diagnoses: Drug-induced high blood sugar and hyponatremia. Interventions: Active management of hyperglycemia during hospitalization and hyponatremia was corrected with active symptomatic treatment. Outcomes: During hospitalization, the patient's hyperglycemia and hyponatremia were effectively managed through active symptomatic treatment. However, following a reduction in the linperlisib dose, the patient developed recurrent hyperglycemia, hyponatremia, and new-onset myalgia. Consequently, the patient declined further linperlisib therapy and permanently discontinued the medication. Lessons: Clinicians should be aware of the risk of complications such as hyperglycemia and hyponatremia in patients with lymphoma and diabetes receiving linperlisib.