Case Report: Voglibose-induced persistent leukopenia in a patient with type 2 diabetes

Aims: 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. Materials and methods: 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. Results: /L, without other interventions. The temporal association and a Naranjo score of 7 supported voglibose as the probable cause of leukopenia. Conclusions: 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.