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Acute Pulmonary Edema Due to Rosiglitazone Use in a Patient With Diabetes Mellitus

73. Sok. 62/3, Emek, Ankara, Turkey; nedimcekmen{at}yahoo.com

Mustafa Cesur, MD

Riza Çetinba, MD

Paa Bedel, MD

Özcan Erdemli, MD

Güven Hospital, Department of Anesthesiology and Intensive Care, Güven Hospital Department of Endocrinology, Kavaklidere, Ankara, Turkey

Rosiglitazone is a peroxisome proliferator active receptor. agonist, which increases insulin sensitivity in adipose tissue, muscle, and liver. Rosiglitazone is a member of the thiazolidinedione group, and because of its significantly positive effect on glycemic control, it is especially preferred in type 2 diabetic patients with a high cardiovascular disease risk. This drug, because of its decreasing effect on insulin resistance, is used alone or combined with type 2 diabetic drugs. A 73-year-old female patient was admitted to the emergency department with dyspnea, pink frothing phlegm, cyanosis, and tiredness. She was lethargic, uncooperative, and had no orientation. In arterial blood gases, hypoxemia and hypercapnia were found. She was taken to the general intensive care unit, and oxygen was applied via mask. The patient had a history of 10 years of diabetes mellitus, hypertension, and atherosclerotic cardiac disease, and she was using rosiglitazone for the past 6 weeks. Her chest x-ray was taken, and acute pulmonary edema was diagnosed. In her last echocardiography, which was performed 1 year before, no signs indicating cardiac failure and pleural effusion could be found. Therefore, it was concluded that pulmonary edema occurred as a complication of rosiglitazone use. After stabilizing the patient's vital signs, blood glucose levels, and lactate levels, medical treatment of diabetes mellitus was rearranged, and she was discharged on the seventh day after her admittance. In a patient with diabetes mellitus who has been admitted to the intensive care unit because of acute pulmonary edema, for differential diagnosis, use of rosiglitazone should be kept in mind during the determination of treatment. Therefore, the authors aim to discuss the effect of rosiglitazone on creating acute pulmonary edema with a case report presentation.

Key Words: rosiglitazone • acute pulmonary edema • type 2 diabetes mellitus • intensive care unit

Journal of Intensive Care Medicine, Vol. 21, No. 1, 47-50 (2006)
DOI: 10.1177/0885066605283385


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