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Unveiling an Uncommon Complication: Pleural Effusion Secondary to Pioglitazone Use

Chimauriya R, Chittal A, Malik K, DuMont T, Haas CJ

Journal of community hospital internal medicine perspectives, 2025

Abstract

Pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, is used in the treatment of Type 2 diabetes mellitus by reducing insulin resistance. While peripheral edema and fluid retention are well-documented adverse effects, isolated pleural effusion in the absence of heart failure is rare. We present the fourth reported case of a woman in her 60s with Type 2 diabetes who developed recurrent left-sided pleural effusion after the initiation and dose escalation of pioglitazone. The effusion resolved completely following discontinuation of the drug. This case underscores the importance of early recognition of drug-induced pleural effusion and timely cessation of the offending agent to prevent morbidity.

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