title: Hydrochlorothiazide-induced noncardiogenic pulmonary edema: BAL fluid analysis.
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.
authors.affiliation: Department of Medical Education, St. Mary Medical Center, 1050 Linden Ave, Long Beach, CA 90813, USA. odarwish@medicity.biz
authors.forename: Omar S
authors.initials: OS
authors.lastname: Darwish
authors.forename: Jasminka
authors.initials: J
authors.lastname: Criley
mesh_terms: D001639:Bicarbonates / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D003937:Diagnosis, Differential; D004232:Diuretics / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D019344:Lactic Acid / Q000032:analysis; D007958:Leukocyte Count; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D009504:Neutrophils; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000175:diagnosis; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed
chemical_list: D001639:Bicarbonates; D004232:Diuretics; D006852:Hydrochlorothiazide; D020097:Natriuretic Peptide, Brain; D019344:Lactic Acid