Rare case of developing pleural, pericardial effusion and anasarca with low-dose oral minoxidil: A report

Following three weeks of the treatment, there was swelling in both lower extremities of the patient, which progressively spread to the upper extremities and face; she was advised to discontinue oral minoxidil and present for follow-up; she was admitted to the hospital for additional workup and further management by a cardiologist.

Following various assessments, the authors excluded other causes of anasarca and pericardial effusion in the previously healthy young woman, concluding that low-dose oral minoxidil was responsible for clinical presentation.

Ncoza C. Dlova, University of Kwazulu Natal, KwaZulu-Natal, South Africa, and colleagues stated in their study, "to the best of our knowledge, the occurrence of pleural, pericardial effusion and anasarca with the LDOM use for alopecia has not been reported in the literature."

"Our extensive workup of the patient did not indicate any obvious underlying cause; thus, we conclude that the woman's presentation was a rare side effect and should be documented to alert other clinicians to be careful about this uncommon adverse effect of LDOM."

They added, "we have since advised patients to initiate alternate days of LDOM for one month and, after that, increase it to daily dosages. This case report alerts clinicians to be mindful of this potential side effect."

Reference:

Dlova NC, Jacobs T, Singh S. Pericardial, pleural effusion and anasarca: A rare complication of low-dose oral minoxidil for hair loss. JAAD Case Rep. 2022 Aug 11;28:94-96. doi: 10.1016/j.jdcr.2022.07.044. PMID: 36117778; PMCID: PMC9478873.