Marrow suppression with myelodysplastic features, hypoerythropoetinemia, and lipotrophic proptosis due to rosiglitazone.
Thiazolidinediones (TZDs) are frequently used pharmacotherapeutics for type II diabetes mellitus, which exert their effect through peroxisomal proliferator agonist receptor (PPAR) mediated increased insulin sensitivity. TZDs are known to cause marrow suppression and to stimulate adipogenesis. Case and cohort studies show TZDs worsen thyroid-associated orbitopathy. We present a case consistent with earlier reports of marrow suppressive pancytopenia manifesting as myelodysplastic syndrome, a new implication of hypoerythropoetinemia, and non-Graves'-associated proliferative proptosis.
Clevidence
Derek E
DE
Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA. derek.clevidence@uwmf.wisc.edu
Juckett
Mark B
MB
Lucarelli
Mark J
MJ
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004921:Erythropoietin / Q000172:deficiency*; D005094:Exophthalmos / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008060:Lipodystrophy / Q000139:chemically induced*; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced*; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000009:adverse effects*
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D004921:Erythropoietin