Pulmonary edema with anasarca associated with Saroglitazar therapy: A case report

Anand D, Sowmyanarayan S

Pdf Page Numbers :- 73-77

Deepak Anand¹, and Sujatha Sowmyanarayan^1,*

¹Department of Medicine, St.Peter’s Medical College, Hospital and Research Institute, Krishnagiri District, Hosur, Tamil Nadu 635130 India

²Department of Pharmacology, St.Peter’s Medical College, Hospital and Research Institute, Krishnagiri District, Hosur, Tamil Nadu 635130 India

*Corresponding author: Dr. Sujatha Sowmyanarayan, Professor, Department of Pharmacology, St.Peter’s Medical College, Hospital and Research Institute, Krishnagiri District, Hosur, Tamil Nadu 635130 India. Email: sowmyanarayansujatha@gmail.com

Received 2 January 2026; Revised 3 March 2026; Accepted 12 March 2026; Published 18 March 2026

Citation: Anand D, Sowmyanarayan S. Pulmonary edema with anasarca associated with Saroglitazar therapy: A case report. J Med Sci Res. 2026; 14(2):73-77. DOI: http://dx.doi.org/10.17727/JMSR.2026/14-14

Copyright: © 2026 Anand D et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Pulmonary edema and anasarca are commonly associated with conditions such as heart failure, renal dysfunction, liver disease, and hypothyroidism. Anasarca refers to severe generalized edema resulting from excessive accumulation of fluid in the interstitial tissues throughout the body. Although Saroglitazar, a dual peroxisome proliferator-activated receptor (PPAR)-α/γ agonist, is widely used in the management of non-alcoholic fatty liver disease (NAFLD) and diabetic dyslipidemia, significant fluid retention leading to pulmonary edema and anasarca has rarely been reported.

Case Presentation: We report the case of a 73-year-old male who developed progressive generalized edema, ascites, and pulmonary edema following treatment with Saroglitazar prescribed at twice the recommended dose for non-alcoholic fatty liver disease. Comprehensive evaluation excluded common causes of fluid overload, including cardiac, renal, hepatic, and thyroid disorders. The temporal relationship between drug exposure and symptom onset, along with clinical improvement following drug withdrawal and treatment with loop diuretics, suggested Saroglitazar-induced pulmonary edema with anasarca.

Conclusion: This case highlights a potentially serious adverse effect of Saroglitazar manifesting as pulmonary edema and generalized fluid retention. Clinicians should be aware of this uncommon reaction, particularly in elderly patients and those receiving higher-than-recommended doses, to facilitate early recognition and appropriate management.

Keywords: Saroglitazar; anasarca; pulmonary edema; adverse drug reaction; fluid retention; PPAR agonist