Severe adverse drug reactions induced by hydrochlorothiazide

Corominas, M.; Andrés-López, Blanca; Lleonart, Ramón

doi:10.1016/j.anai.2016.07.003

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…To date, there have been approximately 60 case reports describing similar idiopathic reactions to HCTZ. 3,9 In fact, one case describes a very similar scenario in which the patient was thought to have multiple episodes of septic shock until her allergic reaction to HCTZ was correctly identified. 4 About 90% of all published case reports are described in women, usually within minutes to hours of taking HCTZ.…”

Section: Discussionmentioning

confidence: 99%

“…1 HCTZ has rarely been shown to cause idiopathic, non-cardiogenic, pulmonary edema, with or without shock, in over 60 case reports since the first publication in 1968. [2][3][4] We describe a case report of a patient transferred to our facility for life-sustaining veno-venous extracorporeal membrane oxygenation (VV-ECMO) secondary to presumed septic shock and acute respiratory distress syndrome (ARDS). It was later concluded that the patient had an allergic reaction to HCTZ, representing the first case report to our knowledge of such a severe reaction to this medication supported by ECMO therapy.…”

Section: Introductionmentioning

confidence: 99%

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Life-threatening idiopathic reaction to hydrochlorothiazide treated with veno-venous extracorporeal membrane oxygenation

Kane

Cohen²

2017

Perfusion

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Hydrochlorothiazide has been shown to cause rare, but serious non-cardiogenic pulmonary edema. We present a case report of a patient with apparent septic shock and acute respiratory distress syndrome (ARDS) requiring life-sustaining veno-venous extracorporeal membrane oxygenation (VV-ECMO). Upon further review of the literature and the chronology of the patient's presentation, her condition was most likely due to an immune-mediated reaction to hydrochlorothiazide. This represents the first case, to our knowledge, of such a severe reaction to hydrochlorothiazide supported with ECMO therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Life-threatening idiopathic reaction to hydrochlorothiazide treated with veno-venous extracorporeal membrane oxygenation

Kane

Cohen²

2017

Perfusion

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“…Otras reacciones cutáneas menos frecuentes son la pustulosis exantemática aguda generalizada 3 y la dermatosis liquenoide bullosa. 4 También se han descrito casos de edema agudo de pulmón, 5,6,7 sin que los mecanismos fi siopatológicos estén bien defi nidos.…”

Section: Antecedentesunclassified

Reacción grave e infrecuente con hidroclorotiazida

Núñez-Acevedo

Domínguez‐Ortega

Rodríguez-Jiménez

et al. 2018

RAM

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Antecedentes: Se desconoce el mecanismo inmunológico implicado en la reacción a la hidroclorotiazida, de amplio uso para el control de la hipertensión arterial. El corto periodo de latencia entre la toma del fármaco y la aparición de síntomas sugiere hipersensibilidad inmediata.Reporte de caso: Mujer de 63 años con hipertensión arterial quien en tres ocasiones presentó náuseas, vómitos, malestar general, tiritona, artralgias, sensación distérmica, dolor lumbar de características mecánicas y tos escasa no productiva, así como fiebre y opresión torácica con incremento de la disnea y desaturación hasta de 88 %, tras la toma de hidroclorotiazida.Conclusiones: La presentación clínica en la paciente fue similar a choque séptico, reacción alérgica rara cuyo diagnóstico es clínico Este tipo de reacción podría deberse a hipersensibilidad tipo III debido a la formación de inmunocomplejos. Evitar el fármaco implicado es clave para la buena evolución.

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“…Despite its efficacy, HCTZ has been associated with several adverse effects, including hyponatremia, hypokalemia, hypotension, phototoxicity and even pulmonary edema and interstitial pneumonia (3). Since the inaugural report documenting the case of HCTZ-induced non-cardiogenic pulmonary edema in 1968 (4), this rare but severe adverse drug reaction has been reported in >60 cases to date (5)(6)(7). However, the primary mechanism underlying HCTZ-induced pulmonary edema remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Mimicking pneumonia with septic shock: A case report and literature review

Guo,

Lin,

Wang

et al. 2023

Exp Ther Med

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Hydrochlorothiazide (HCTZ) is a commonly used diuretic antihypertensive drug that can cause electrolyte disorders, hyperglycemia and hyperuricemia as well as rare life-threatening adverse drug reactions. These include non-cardiogenic pulmonary edema, interstitial pneumonia, angioedema and aplastic anemia. The present report describes a case of a 59-year-old man who developed a hypersensitivity reaction to HCTZ. Specifically, the patient presented with symptoms of cough, chest tightness and shortness of breath, with pneumonic consolidation on chest CT and elevated levels of white blood cell count, neutrophil percentage, C-reactive protein and procalcitonin. A presumptive diagnosis of severe pneumonia was made initially. However, during the gradual recovery of the patient through treatment, he mistakenly ingested HCTZ containing losartan potassium intended for another patient, which resulted in symptoms similar to those observed upon admission. Upon further inquiry into the medical history, it was revealed that the patient had also taken irbesartan/HCTZ 4 h prior to hospitalization. There was no evidence of a pathogenic infection. Therefore, HCTZ-induced anaphylactic reaction was considered to be the most likely etiology for his severe shock. Treatments including epinephrine, methylprednisolone and respiratory support were administered. After 7 days, the patient was transferred from the Respiratory Intensive Care Unit [The Affiliated Jiangning Hospital of Nanjing Medical University (Nanjing, China)] to a general ward. During the follow-up, 12 months after advising the patient to discontinue HCTZ, there had been no recurrence of the aforementioned symptoms. At the time of publication, the patient is currently alive.

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Severe adverse drug reactions induced by hydrochlorothiazide

Cited by 6 publications

References 6 publications

Life-threatening idiopathic reaction to hydrochlorothiazide treated with veno-venous extracorporeal membrane oxygenation

Life-threatening idiopathic reaction to hydrochlorothiazide treated with veno-venous extracorporeal membrane oxygenation

Reacción grave e infrecuente con hidroclorotiazida

Mimicking pneumonia with septic shock: A case report and literature review

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