Thiazolidinediones are currently indicated for the treatment of Type 2 Diabetes. This class of drugs has been associated with several adverse reactions associated with volume overload. This report describes a case of a 65 year old African—American female with a history of hypertension and obesity, and taking rosiglitazone (Avandia) for her Type 2 Diabetes whose evaluation for chest pain resulted in the incidental finding of pulmonary hypertension noted on echocardiogram. The subsequent evaluation, follow-up and treatment are discussed along with potential pitfalls and implications for clinical care.
Alpert, M.A. (2001) Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome, American Journal of the Medical Sciences. 321: 225-236.
2.
American College of Cardiology. (2004) Pulmonary arterial hypertension: epidemiology, pathobiology, assessment, and therapy, J Am Coll Cardiol. 43: June supplement 1S-90S.
3.
American College of Chest Physicians. (2004 ) Diagnosis and management of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines, Chest. 126: July supplement 1S-92S .
4.
Atwood, Jr, C.W., McCrory, D., Garcia, J.G., Abman, S.H. and Ahearn, G.S. (2004) American College of Chest Physicians. Pulmonary artery hypertension and sleep-disordered breathing: ACCP evidence-based clinical practice guidelines, Chest. 126(1 Suppl): 72S-77S.
5.
Badesch, D.B., Abman, S.H., Simonneau, G., Rubin, L.J. and McLaughlin, V.V. (2007) Medical therapy for pulmonary arterial hypertension updated ACCP evidence-based clinical practice guidelines , Chest. 131: 1917-1928.
6.
Glaxo SmithKline Pharmaceuticals. (2007) Avandia (rosiglitazone maleate). Package Insert. Research Triangle, NC, USA.
7.
McGoon, M., Gutterman, D., Steen, V., Barst, R., McCrory, D.C., Fortin, T.A. et al. (2004) American college of chest physicians. Screening, early detection, and diagnosis of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines, Chest. 126(1 Suppl): 14S-34S.
Nissen, S.E. and Wolski, K. (2007) Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes, N Engl J Med. 356: 2457-2471.
11.
Raskin, P., Rendell, M., Riddle, M.C., Dole, J.F., Freed, M.I. and Rosenstock, J. (2001) A randomized trial of rosiglitazone therapy in patients with inadequately controlled insulin-treated type 2 diabetes, Diabetes Care. 24: 1226-1232.
12.
Rubin, C., Egan, J. and Schacider, R. (1999) Combination therapy with pioglitazone and insulin in patients with type 2 diabetes (Abstract), Diabetes.48(Suppl. 1): A110.
13.
Wang, F., Aleksunes, L.M., Reagan, L.A. and Vergara, C.M. (2002) Management of rosiglitazone-induced edema: two case reports and a review of the literature, Diabetes Technology & Therapeutics. 4: 505-514.