SGLT2 and blood count

Q: sodium-glucose co-transporter 2 (SGLT2) inhibitors may induce? (select one)

A) Anemia

B) Polycythemia

Answer: B

Conventionally, it is believed that all drugs tend to cause anemia, but this is not true. Some drugs can cause polycythemia as well. Some well-known drugs are erythropoietin (EPO), testosterone/anabolic steroids, and performance-enhancement drugs. SGLT2 is a new addition to the list. 

Diuretics do not cause pure polycythemia, but by decreasing serum/cell ratio, it causes pseudo-polycythemia.

#pharmacology

#hematology

References:

1. Sano M, Goto S. Possible Mechanism of Hematocrit Elevation by Sodium Glucose Cotransporter 2 Inhibitors and Associated Beneficial Renal and Cardiovascular Effects. Circulation 2019; 139:1985.

2. Chin-Yee B, Solh Z, Hsia C. Erythrocytosis induced by sodium-glucose cotransporter-2 inhibitors. CMAJ 2020; 192:E1271.