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Hydrochlorothiazide-induced acute pulmonary edema
S R Fine1, A Lodha, S Zoneraich
1Division of Allergy and Immunology, Albert Einstein College of Medicine, Flushing Hospital Medical Center, NY 11355, USA.
The Annals of Pharmacotherapy
|July 1, 1995
Summary
Hydrochlorothiazide can cause noncardiogenic pulmonary edema, a rare but serious side effect. This reaction appears idiosyncratic and occurs with thiazide diuretics, necessitating clinical awareness.
Area of Science:
- Pharmacology
- Pulmonology
- Toxicology
Background:
- Hydrochlorothiazide is a common thiazide diuretic used for hypertension and edema.
- Noncardiogenic pulmonary edema is a rare but severe adverse reaction.
- The pathogenesis of this reaction remains largely unknown.
Observation:
- A 70-year-old woman developed acute noncardiogenic pulmonary edema after her first dose of hydrochlorothiazide.
- The patient had mild pedal edema prior to the event.
- This represents the fifteenth reported case of such a reaction.
Findings:
- Noncardiogenic pulmonary edema induced by hydrochlorothiazide is an idiosyncratic reaction.
- The reaction shows specificity with thiazide diuretics.
- Immunologic mechanisms have been largely ruled out in previous cases.
Implications:
- Clinicians must be aware of this potential serious adverse reaction to hydrochlorothiazide.
- The reaction occurs unpredictably and without warning.
- This highlights the importance of careful medication review and patient monitoring for diuretic-induced pulmonary edema.