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Hydrochlorothiazide-induced noncardiogenic pulmonary edema: BAL fluid analysis
Omar S Darwish1, Jasminka Criley
1Department of Medical Education, St. Mary Medical Center, 1050 Linden Ave, Long Beach, CA 90813, USA. odarwish@medicity.biz
Abstract:
Hydrochlorothiazide (HCTZ)-induced pulmonary disease has been described as either an allergic interstitial pneumonitis or a cause of noncardiogenic pulmonary edema. The mechanism of this rare life-threatening side effect is largely unknown. Many patients show peripheral leukopenia and extensive immunologic studies reveal decreased levels of serum immunoglobulins. However, evaluation of the peripheral blood may not reflect local lung changes. Literature reports of bronchoalveolar differentials on such patients are scarce. Bronchoscopy was performed on our patient, and the lavage revealed a significant percentage of neutrophils (70%) and no eosinophils.
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