{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T11:42:01Z","timestamp":1788090121194,"version":"build-2803163510"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>While alpha-glucosidase inhibitors like voglibose are generally considered safe, hematological adverse effects such as leukopenia are exceedingly rare. This case report investigates a potential causal link between long-term voglibose use and persistent leukopenia in a diabetic patient, emphasizing the importance of considering drug-induced cytopenia in unexplained leukopenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We describe a 71-year-old male with well-controlled type 2 diabetes who developed leukopenia over five years. After extensive evaluation, including bone marrow biopsy showing hypoplasia, and ineffective leukopoietic treatment, a multidisciplinary review identified long-term voglibose use as a possible cause. The drug was replaced with acarbose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two weeks after switching to acarbose, the patient\u2019s white blood cell count rose from a persistent range of 2.69\u20133.32 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L to 3.89\u20133.98 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L, without other interventions. The temporal association and a Naranjo score of 7 supported voglibose as the probable cause of leukopenia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case suggests that voglibose may rarely induce chronic leukopenia, especially with prolonged use. In diabetic patients with unexplained cytopenia, clinicians may consider medication review and therapeutic substitution as a diagnostic and management strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1839471","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:29:50Z","timestamp":1780547390000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Voglibose-induced persistent leukopenia in a patient with type 2 diabetes"],"prefix":"10.3389","volume":"17","author":[{"given":"Jing-wen","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Pharmacy, the First Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-hong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, the First Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-shuang","family":"Chang","sequence":"additional","affiliation":[{"name":"College of Clinical Pharmacy, Shenyang Pharmaceutical University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, the First Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-qiu","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, the First Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen-qin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, the First Hospital of China Medical University","place":["Shenyang, Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.108.148056","article-title":"Chronic administration of voglibose, an alpha-glucosidase inhibitor, increases active glucagon-like peptide-1 levels by increasing its secretion and decreasing dipeptidyl peptidase-4 activity in ob\/ob mice","volume":"329","author":"Moritoh","year":"2009","journal-title":"J Pharmacol Exp Ther"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s2352-3026(22)00145-4","article-title":"Short versus extended treatment with a carbapenem in patients with high-risk fever of unknown origin during neutropenia: a non-inferiority, open-label, multicentre, randomised trial","volume":"9","author":"de Jonge","year":"2022","journal-title":"Lancet Haematol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"19336","DOI":"10.1038\/s41598-023-46307-5","article-title":"Antithyroid drug-induced leukopenia and G-CSF administration: a long-term cohort study","volume":"13","author":"Kamitani","year":"2023","journal-title":"Sci Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1186\/s12888-023-04902-w","article-title":"The lived experience of clozapine discontinuation in patients and carers following suspected clozapine-induced neutropenia","volume":"23","author":"Oloyede","year":"2023","journal-title":"BMC Psychiatry"},{"key":"B5","article-title":"Analysis of 2808 cases of spontaneous report associated with drug - 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