Thiazide-induced pulmonary edema: a case report

A 42-year-old white female developed severe respiratory distress 30 minutes following the ingestion of hydrochlorothiazide. On her arrival at the emergency room, pulmonary edema was evident by physical examination and chest radiograph. She presented without evidence of a gallop, jugular venous distention, or history suggesting cardiac disease. Normal electrocardiogram (ECG) and echocardiogram, and a radionuclide ventriculogram showing normal systolic and diastolic functions supported the noncardiac origin. The patient responded to supportive treatment within hours although the radiographic abnormalities persisted for several days. A review of the literature revealed that at least 12 other cases have been described of this unusual but life threatening idiosyncratic reaction to hydrochlorothiazide.