Metformin: A Common Drug and a Rare Trigger of Hemolytic Reactions

Metformin-induced hemolytic anemia (MIHA) is a rare adverse effect of the drug metformin, which can cause serious morbidity and result in mortality if not recognized promptly. We present the first MIHA case to be reported in the Kingdom of Bahrain. The case revolves around a 50-year-old male, who was newly diagnosed with diabetes and recently initiated on metformin therapy, presenting to the emergency department with progressive hemolytic anemia. After laboratory investigations ruled out various differentials, a joint decision made by the endocrinologist and hematologist to discontinue metformin led to a notable improvement in symptoms and the complete resolution of the patient’s hemolytic anemia.