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Acute allergic interstitial pneumonitis induced by hydrochlorothiazide
P Biron1, J Dessureault, E Napke
1Department of Pharmacology, Université de Montréal, PQ.
Summary
Acute allergic interstitial pneumonitis from hydrochlorothiazide (HCT) is rare but potentially fatal. Suspect this condition in unexplained acute pulmonary edema, as avoidance of HCT is the only prevention.
Area of Science:
- Pulmonology
- Pharmacovigilance
- Toxicology
Background:
- Hydrochlorothiazide (HCT) is a common diuretic.
- Allergic interstitial pneumonitis is a rare but serious adverse drug reaction.
Observation:
- This study reviewed 4 unpublished and 26 published cases of HCT-induced acute allergic interstitial pneumonitis.
- The reaction onset was rapid (average 44 minutes), predominantly affecting women (90%) aged 56 years.
- Some cases were severe, requiring mechanical ventilation, and one was fatal.
Findings:
- Rechallenge confirmed HCT as the causative agent in some instances.
- Clinical presentation mimicked unexplained acute pulmonary edema.
- Supportive care and HCT avoidance were key management strategies.
Implications:
- Clinicians must consider HCT as a potential cause of acute allergic interstitial pneumonitis.
- Early diagnosis and HCT withdrawal are crucial for patient outcomes.
- Increased awareness may prevent severe or fatal reactions to this common medication.