Rosiglitazone-induced anasarca without heart failure: capillary leakage?
Severity of thiazolidinedione (Rosiglitazone)-induced fluid retention is linked almost exclusively to cardiac decompensation. We here report a 68-year old female with type 2 diabetes mellitus, in whom a life-threatening (anasarca type) acute pulmonary edema, induced by rosiglitazone plus insulin therapy, occurred without any evidence of left ventricular systolic or diastolic dysfunction. It seems that thiazolidinedione-induced severe edema does not have to be the result of acute congestive heart failure. These agents have been shown to increase vascular permeability in experimental models. Thus, the recommendation of only cardiac monitoring in pulmonary edema, associated with thiazolidinediones, should be reconsidered.
Dagdelen
Selcuk
S
Hacettepe University School of Medicine, Department of Endocrinology, Ankara Turkey. dagdelen@hacettepe.edu.tr
Kurt
Mevlut
M
Aydin
Kadriye
K
Bayraktar
Miyase
M
D000368:Aged; D002199:Capillary Permeability / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006333:Heart Failure; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007328:Insulin / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000139:chemically induced*; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000009:adverse effects*
D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones; D000077154:Rosiglitazone