Case
Published · Updated · 2 min read
Belimumab, metformin and sevoflurane: reports of serious adverse reactions
What it means for practice
The reports highlight monitoring mental health during belimumab treatment and considering possible liver injury after sevoflurane. Immediate suspension of metformin during dehydration is emphasized.
Summary
The bulletin Automne 2026 – N°19 highlights pharmacovigilance reports involving belimumab, metformin and sevoflurane. The abstract describes cases of psychiatric disturbances, fatal lactic acidosis and drug-induced liver injury. Its main emphasis is timely recognition of these risks and appropriate management in clinical practice.
Reported cases
- Belimumab: two adolescent cases of psychiatric decompensation and suicidal ideation during treatment are reported.
- Metformin: a case of fatal lactic acidosis in the setting of dehydration is described. The report emphasizes the need for immediate suspension of the drug during dehydration.
- Sevoflurane: a case of drug-induced liver injury associated with anesthesia using this agent is reported.
Limits of interpretation
The abstract provides no doses, treatment durations, time to reaction onset, investigation results or formal causality assessment. Patient ages in the metformin and sevoflurane cases are not stated. These details are insufficient for an independent assessment of causality or reaction frequency; the reports should be viewed as clinical cautions rather than a quantitative risk estimate.
Case analysis
- Likely mechanism
- The abstract does not describe the mechanisms of the reported reactions. Dehydration is noted in the case of metformin-associated lactic acidosis, but its role in the reaction mechanism is not detailed.
- Causality assessment
- The abstract provides no author-reported Naranjo score or WHO-UMC category. Information on temporal relationships, dechallenge, rechallenge and alternative causes is insufficient for an editorial causality classification.
- Take-home lesson
- The reports highlight the importance of monitoring mental health in adolescents receiving belimumab and considering possible drug-induced liver injury after sevoflurane anesthesia. The metformin case emphasizes immediate suspension of treatment during dehydration.
Source
-
Automne 2026 – N°19.
Reviewed by: DrugCard editorial team ·
This article does not replace clinical judgement. Disclaimer
