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      Edema pulmonar agudo por hidroclorotiazida: una reacción adversa poco conocida Translated title: Hydrochlorothiazide-induced acute pulmonary edema: a rare adverse reaction

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          Abstract

          En Chile, la hidroclorotiazida se utiliza ampliamente como terapia de primera línea en la hipertensión arterial esencial. Entre los efectos adversos más conocidos destacan: trastornos hidroelectrolíticos, hiperuricemia, dislipidemia, azotemia, entre otros. El edema pulmonar agudo es un efecto adverso infrecuente y potencialmente grave. Desde 1968, se han reportado 50 casos clínicos en la literatura. En este artículo presentamos el caso clínico de una mujer de 70 años atendida en el Hospital Santiago Oriente quien, una hora posterior a la ingesta de hidroclorotiazida, presenta disnea aguda progresiva. El estudio clínico y radiológico es compatible con edema pulmonar agudo no cardiogénico.

          Translated abstract

          In Chile, hydrochlorothiazide is frequently prescribed as first line antihypertensive therapy. Among it’s well known adverse reactions are: electrolytic disorders, hyperuricemia, dyslipidemia, agranulocytosis and azotemia. Acute pulmonary edema is a rare and potentially lethal adverse effect. Only 50 cases have been reported since 1968. In this article, we discuss a case of a 70 year old woman who, one hour after the ingestion of hydrochlorotiazide, presented acute and progressive dyspnea. Her clinical and radiologic findings are compatible with non-cardiogenic acute pulmonary edema.

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          Most cited references20

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          Drug-induced noncardiogenic pulmonary edema.

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            Utility of point-of-care testing of natriuretic peptides (brain natriuretic peptide and n-terminal pro-brain natriuretic peptide) in the emergency department

            Rapid and accurate diagnosis of a patient with an acute disease is a challenge for emergency physicians. Natriuretic peptides have emerged as important tools for diagnosis, risk stratification and therapeutic decision making for some categories of emergency patients. Brain natriuretic peptide (BNP) is a member of a four natriuretic peptides family that shares a common 17-peptide ring structure. Atrial natriuretic peptide, C-natriuretic peptide (CNP), and D-type natriuretic peptide are the other natriuretic peptide, which share the same common 17-peptide ring structure. The N-terminal fragment of pro-BNP, N-terminal pro-brain natriuretic peptide (NT-proBNP) consists of 76 amino acids, which is biologically inert, while the active component BNP contains 32 amino acids. BNP and NT-proBNP are secreted in the plasma in equimolar quantities and are frequently used in the diagnosis of congestive heart failure, and distinguishing between patients with dyspnea of cardiac or pulmonary origin. Both natriuretic peptides have also been evaluated for use in the assessment and management of several other conditions including sepsis, cirrhosis of liver and renal failure. However, one should remember that the values of natriuretic peptides are affected by age and weight of the patients, and presence of several comorbidities such as chronic renal failure, type 2 diabetes mellitus, anemia, pulmonary embolism, and acute coronary syndrome. Values of these peptides also vary depending on the type of test used. The performance characteristics of these natriuretic peptides vary depending on the patients on whom they are used. Therefore determination of reference values for these peptides represents a challenge.
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              Basophil activation in two cases of hydrochlorothiazide-induced noncardiogenic pulmonary edema

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                Author and article information

                Journal
                rcher
                Revista chilena de enfermedades respiratorias
                Rev. chil. enferm. respir.
                Sociedad Chilena de Enfermedades Respiratorias (Santiago, , Chile )
                0717-7348
                June 2015
                : 31
                : 2
                : 105-108
                Affiliations
                [03] orgnameHospital Santiago Oriente Chile
                [02] orgnameInstituto Nacional del Tórax Chile
                [01] orgnameUniversidad de Chile Chile
                Article
                S0717-73482015000200006 S0717-7348(15)03100200006
                6d2b1abe-a363-426c-a4d1-514567fe4aa3

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 4
                Product

                SciELO Chile

                Categories
                Casos Clínicos

                unidad de cuidados intensivos,Acute pulmonary edema,hidrochlorothiazide,intensive care unit,Edema pulmonar agudo,drugs side effects,reacción adversa a medicamentos,hidroclorotiazida

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