|ISSN No. 1606-7754 Vol.16 No.2 August 2008|
Proptosis secondary to rosiglitazone treatment
Chun Cheng Lin Yang1, Chih Hao Chen-Ku2, Reza M Vagefi1, Richard L Anderson1, John McCann1
Center for Facial Appearances, Salt Lake City, Utah, United States1; Department of Endocrinology, Hospital San Juan de Dios, San Josť, Costa Rica2
Objective: To report a case of new onset proptosis secondary to treatment with rosiglitazone. Methods: Case report Results: A patient developed symptomatic bilateral proptosis requiring surgical intervention, two years and a half after treatment with rosiglitazone. Conclusion: Asymptomatic eye protrussion is a frequent finding in patients treated with thiazolidinediones. In a few cases, the proptosis may be clinically significant and may present in patients with or without a previous history of thyroid disease.
Key words: proptosis, rosiglitazone, thiazolidinediones, ocular complication
Rosiglitazone and pioglitazone are two thiazolidinediones (TZDs) used to treat type 2 diabetes mellitus. TZDs act by sensitizing tissues to insulin action through binding to the peroxisome proliferator-activated receptor-gamma (PPARγ). This nuclear receptor is predominantly found in adipose tissues and has a key role in adipocyte differentiation, associated with well-described weight gain by the generalized increase in subcutaneous fat volume.1 Proptosis in Type I thyroid orbitopathy has been found to correlate well with expansion of the orbital fat compartment, secondary to enhanced orbital adipogenesis.2,3 Presentation of proptosis after thiazolidinedione use in type 2 diabetes patients associated with or without thyroid disease has been reported recently.4-7 We report a case of proptosis with rosiglitazone use not associated with thyroid disease.