Background: Hydroxychloroquine (HCQ) is a synthetic anti-malarial drug and has been used for the treatment of rheumatic diseases. Recently, HCQ has been reported to improve lipid and glucose metabolism in patients with rheumatic diseases. However, effects of HCQ on lipid and glucose metabolism in Japanese remain unknown. Methods: We picked up patients who had been prescribed HCQ for 1 month or longer between September 2015 and August 2018. We compared the data at baseline and at 1-11 months after the start of HCQ. We excluded patients who discontinued to take HCQ due to adverse reaction, and patients who had taken daily more than 20 mg of prednisolone with HCQ. Results: We found 40 patients, and excluded nine patients who discontinued to take HCQ due to adverse reactions and five patients who had taken daily more than 20 mg of prednisolone in addition to HCQ, and we analyzed 26 patients. Twenty-two systemic lupus erythematosus (SLE) patients and 4 rheumatoid arthritis (RA) patients had been prescribed HCQ. Hemoglobin A1c (HbA1c) showed a significant decrease and tendency to decrease at 5 and 6 months after the start of HCQ, respectively. At other time points, HbA1c showed non-significant decrease. Serum triglyceride showed a significant decrease at 1, 3, 7, 8 and 11 months after the start of HCQ. At other time points, serum triglyceride showed non-significant decrease. Serum high-density lipoprotein-cholesterol (HDL-C) did not show any significant changes at every time point. Serum low-density lipoproteincholesterol (LDL-C) showed a significant decrease at 2 months after the start of HCQ and showed tendency to decrease after 7 and 10 months. At other time points, serum LDL-C showed non-significant decrease. Serum non-HDL-C showed a significant decrease at 2, 3 and 7 months after the start of HCQ and showed tendency to decrease after 1 and 5 months. At other time points, serum non-HDL-C showed non-significant decrease. Conclusion: HCQ was associated with reduction of HbA1c, serum triglyceride, LDL-C and non-HDL-C levels in SLE and RA patients.

Streptococcus agalactiae, a group B streptococcus (GBS), has been considered to be a major pathogen in neonates and pregnant women. Recently, there is accumulating concern about its significance for pathogenesis in non-pregnant adult patients. Diabetes is one of the most important underlying diseases for the development of GBS infection. This review will focus on the risk factors and clinical manifestations of GBS infections, and also introduce two patients with hyperglycemic hyperosmolar syndrome and diabetic ketosis who were complicated with pneumonia due to GBS.

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