• Am J Emerg Med · Jun 2020

    Case Reports

    Hydrochlorothiazide-induced systemic capillary leak.

    • Peter Vadas.
    • Division of Clinical Immunology and Allergy, Department of Medicine, St. Michael's Hospital, University of Toronto, Canada. Electronic address: Peter.Vadas@unityhealth.to.
    • Am J Emerg Med. 2020 Jun 1; 38 (6): 1299.e1-1299.e2.

    AbstractHypersensitivity reactions to drugs may cause very rapid physiologic derangements that can be fatal in the absence of adequate compensatory mechanisms or definitive treatment. For the most part, adverse drug reactions that progress over the course of minutes are mediated either by mast cell or complement activation. If a patient survives the acute event, appropriate long-term management requires the identification and future avoidance of the inciting drug. Here, we describe a patient who experienced two life-threatening multisystem reactions with cardiopulmonary compromise minutes after taking hydrochlorothiazide (HCTZ). The reactions were associated with systemic vascular leak resulting in hypotension and non-cardiogenic pulmonary edema.Copyright © 2020. Published by Elsevier Inc.

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