Traversa Matteo, Collini Andrea, Villois Paola, Elia Fabrizio, Verhovez Andrea, Aprà Franco
Internal Medicine, Città della Salute e della Scienza di Torino, Torino, Italy.
Emergency Medicine, Città della Salute e della Scienza di Torino, Torino, Italy.
Eur J Case Rep Intern Med. 2018 Jun 26;5(6):000864. doi: 10.12890/2018_000864. eCollection 2018.
Hydrochlorothiazide (HCTZ) is one of the most popular drugs for the treatment of hypertension and heart failure. Most of its side effects are harmless and predictable, but some studies report a few life-threatening reactions to this drug, one of the most dangerous being acute pulmonary oedema.
A 73-year-old woman was admitted to the Emergency Department with acute respiratory failure due to pulmonary oedema. Her past medical history included long-lasting hypertension with permanent atrial fibrillation and mitral stenosis. Her blood pressure control had been suboptimal, so her cardiologist had changed amlodipine to combination therapy with ramipril and HCTZ. However, 20 min after taking the new drug, the patient experienced fever, vomiting and diarrhoea immediately followed by acute onset of dyspnoea.
Since HCTZ is one of the most popular drugs for hypertension treatment and millions of patients take it every day, it is important to keep in mind both the common adverse reactions as well as the dangerous, although rare, ones.
Pulmonary oedema is a very unusual adverse reaction to hydrochlorothiazide, and a rare presentation of a common condition.Pulmonary oedema is not always due to heart problems.It is important to keep in mind that hypersensitivity reactions may have many different presentations.
氢氯噻嗪（HCTZ）是治疗高血压和心力衰竭最常用的药物之一。其大多数副作用无害且可预测，但一些研究报告了该药物的一些危及生命的反应，其中最危险的一种是急性肺水肿。
一名73岁女性因肺水肿导致急性呼吸衰竭入住急诊科。她的既往病史包括长期高血压伴永久性心房颤动和二尖瓣狭窄。她的血压控制欠佳，因此她的心脏病专家将氨氯地平改为与雷米普利和氢氯噻嗪联合治疗。然而，服用新药20分钟后，患者立即出现发热、呕吐和腹泻，随后急性呼吸困难发作。
由于氢氯噻嗪是治疗高血压最常用的药物之一，每天有数百万患者服用，因此既要牢记常见的不良反应，也要牢记危险但罕见的不良反应。
肺水肿是氢氯噻嗪非常罕见的不良反应，是一种常见疾病的罕见表现。肺水肿并不总是由心脏问题引起。重要的是要牢记过敏反应可能有许多不同的表现形式。
