Pioglitazone-induced Pulmonary Injury in a Very Elderly Patient

Abstract

An 85-year-old woman with diabetes mellitus was admitted to our hospital due to progressive dyspnea. Two months previously, pioglitazone had been newly prescribed for diabetes management. Bilateral groundglass opacities and progressive respiratory deterioration suggested respiratory failure due to a drug-induced lung injury. With discontinuation of pioglitazone and the administration of a corticosteroid, an improvement in her respiratory condition was achieved, although sequelae remained in some areas of the lungs. Results of drug-induced lymphocyte stimulation tests were positive for pioglitazone. Resumption of other drugs did not reinduce the lung injury. Therefore, a diagnosis of pioglitazone-induced lung injury was made. Although pioglitazone-induced lung injury is very rare, clinicians should keep it in mind when pioglitazone is used.

Interstitial lung disease and diabetes

“…Pioglitazone with its potent anti-inflammatory action has shown to ameliorate bleomycin-induced acute inflammatory response and fibrotic changes in rats and is being studied as a potential treatment for pulmonary fibrosis[ 39 ]. One case of pioglitazone induced acute lung injury has been reported in Japan[ 40 ]. Glibenclamide is a commonly used sulfonylurea drug in the treatment of type 2 DM.…”