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Pleural Effusion and Anasarca Associated With Pioglitazone
Ashwin Jagadish1, Shahnawaz Notta1, Stephen Bakeler1
1James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
Summary
Pioglitazone, used for type 2 diabetes, may cause fluid buildup, including rare pleural effusions and anasarca. Discontinuation of the drug led to patient recovery.
Area of Science:
- Endocrinology
- Cardiology
- Pulmonology
Background:
- Pioglitazone is a thiazolidinedione medication for type 2 diabetes mellitus (T2DM).
- Common adverse effects include edema and weight gain; heart failure is a known risk.
- Pleural effusions are an uncommon adverse effect associated with pioglitazone.
Observation:
- An 81-year-old male with T2DM presented with worsening lower extremity edema and dyspnea.
- Symptoms emerged after initiating pioglitazone therapy.
- The patient exhibited a large pleural effusion and diffuse anasarca.
Findings:
- Discontinuation of pioglitazone resulted in symptom improvement.
- The patient underwent successful thoracentesis and diuresis.
- The Naranjo scale indicated a probable association between pioglitazone and the patient's condition (score of 7).
Implications:
- This case highlights a rare presentation of pleural effusion and anasarca potentially linked to pioglitazone.
- Physicians should consider pioglitazone as a potential cause of unexplained fluid accumulation.
- Further research is warranted to understand the mechanism and incidence of pioglitazone-induced pleural effusions.
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