Résumé
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.
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.
Sujets)
Humains , Femelle , Sujet âgé , Oedème pulmonaire/induit chimiquement , Diurétiques/effets indésirables , Hydrochlorothiazide/effets indésirables , Oedème pulmonaire/imagerie diagnostique , Tomodensitométrie/méthodes , Maladie aigüe , Inhibiteurs du symport chlorure sodium/effets indésirables , Unités de soins intensifsRésumé
We report a 58 years old male that developed a bone marrow aplasia associated to the use of ticlopidine, prescribed after coronary artery stenting. The patient developed a pneumonia as a complication. He was admitted to the Intermediate Treatment Unit, receiving wide spectrum antimicrobial therapy and a granulocyte colony stimulating factor (Neupogen(r)) with favourable response. Ticlodipine is an effective anti-platelet agent, but has serious hematological and other side effects. Its prescription requires a close follow up and search for complications