Key result
Pioglitazone linked to large pleural effusion and diffuse anasarca in a T2D patient.
Why the study?
Pioglitazone is not commonly associated with pleural effusions, and there is limited documentation of pleural effusions associated with its use.
Does pioglitazone cause pleural effusion and anasarca in patients with type 2 diabetes mellitus?
Case Report (n=1)
Does pioglitazone cause pleural effusion and anasarca in patients with type 2 diabetes mellitus?
Pioglitazone therapy may be associated with the rare but significant adverse effects of pleural effusion and anasarca, which clinicians should consider when evaluating patients on this medication.
May signal rare pioglitazone-related fluid retention in elderly patients; hypothesis-generating and requires confirmation in larger studies.
Introduction: Pioglitazone is a medication that can be utilized in the management of type 2 diabetes mellitus (T2DM). It can be associated with adverse effects such as edema, weight gain, and heart failure. It is not commonly associated with pleural effusions. Case Presentation: Our case involves an 81-year-old man with T2DM who presented to the emergency department due to progressively worsening lower extremity edema and exertional dyspnea. These symptoms began after the patient started to regularly take pioglitazone. He had a large pleural effusion and diffuse anasarca. Pioglitazone was discontinued and he underwent successful thoracentesis and diuresis. Discussion: The Naranjo scale yielded a score of 7 points, indicating a probable association between pioglitazone and our patient’s presentation. There is limited documentation of pleural effusions associated with pioglitazone. Our case is unique as the patient had pleural effusions and anasarca associated with pioglitazone.
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Jagadish et al. (2025) conducted a case report in Type 2 diabetes mellitus (n=1). Pioglitazone was evaluated on Development of pleural effusion and anasarca. Pioglitazone use in an 81-year-old man with type 2 diabetes was probably associated with the development of a large pleural effusion and diffuse anasarca (Naranjo scale score 7).
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