Drug-induced Noncardiogenic Pulmonary Edema

Reed, Christopher Robert; Glauser, Frederick L.

doi:10.1378/chest.100.4.1120

Cited by 69 publications

(31 citation statements)

References 43 publications

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“…Acetazolamide is classified into a sulfonamide group for its structure. It has been known that the group, for example, hydrochlorothiazide and sulfamethoxazole, causes non‐cardiogenic pulmonary edema 7. Hence, the pathophysiology is thought to be associated with both sulfonamide cross‐sensitivity and its immunomediated mechanism,1, 3 which could increase the capillary endothelium permeability leading protein and fluid to enter the lung parenchyma and alveolar spaces 8.…”

Section: Discussionmentioning

confidence: 99%

A case of non‐cardiogenic pulmonary edema provoked by intravenous acetazolamide

Ono¹,

Morifusa²,

Ikeda³

et al. 2017

Acute Medicine & Surgery

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CaseA 61‐year‐old man was diagnosed with severe chest trauma after a car accident and had had difficulty in weaning from a ventilator because of flail chest and dilated cardiomyopathy. On the 17th day in the intensive care unit, he received i.v. acetazolamide to increase urine output. One hour after the injection, he suddenly developed severe hypoxia. Chest radiography revealed a butterfly shadow. He received other diuretics and a vasodilator, which seemed slowly to resolve the respiratory failure. Five days later, acetazolamide was again given and he experienced the same deterioration.OutcomeWe concluded that the episodes were attributed to pulmonary edema provoked by acetazolamide.ConclusionAcute non‐cardiogenic pulmonary edema is an uncommon and lethal adverse effect of acetazolamide. Careful attention may be warranted when administering acetazolamide to critically ill patients.

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Section: Discussionmentioning

confidence: 99%

A case of non‐cardiogenic pulmonary edema provoked by intravenous acetazolamide

Ono¹,

Morifusa²,

Ikeda³

et al. 2017

Acute Medicine & Surgery

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“…Entre los numerosos fármacos implicados destacan: opiáceos, tocolíticos, salicilatos, hidroclorotiacida, protamina, ciclosporina, antidepresivos tricíclicos, amiodarona, alcaloides de la vinca y bleomicina 7 .…”

Section: Discussionunclassified

Edema de pulmón precipitado por amlodipino

Castaño¹,

Ríos²

2013

Gal. Clin.

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ResumenMúltiples fármacos pueden causar edema agudo de pulmón no cardiogé-nico. Establecer esta relación causal resulta muy difícil en muchos casos debido a la escasa incidencia documentada con algunos fármacos y a que la sintomatología no es específica. Si bien el edema periférico es un efecto secundario frecuente del amlodipino, solamente se han publicado en la literatura dos casos de edema pulmonar causado por amlodipino y ambos ocurrieron en el contexto de dosis supraterapéuticas. Se describe un caso excepcional de edema pulmonar probablemente inducido por amlodipino administrado a dosis terapéutica y se discute el posible mecanismo fisiopatológico.Palabras clave: Amlodipino. Edema pulmonar. Efecto secundario. AbstractMultiple drugs can cause non-cardiogenic acute pulmonary edema. Most of the time, establishing this causal relationship is very difficult due to low reported incidence of drug adverse effects and non specific symptoms. Peripheral edema is a common side effect of amlodipine; but only two cases of pulmonary edema caused by amlodipine have been published in the literature and both occurred in the context of drug overdose. We describe a unique case of pulmonary edema probably induced by amlodipine at therapeutic doses and we discuss the possible pathophysiological mechanism.Key words: Amlodipine. Pulmonary edema. Adverse effects. IntroducciónAmlodipino es un inhibidor de la entrada de iones calcio del grupo de las dihidropiridinas (antagonista del calcio) que impide el paso de los iones de calcio a través de la membrana celular en el músculo cardíaco y en el músculo liso vascular, provocando una vasodilatación por relajación directa 1 . Empleado en el tratamiento de la hipertensión arterial y la angina, entre los efectos secundarios más frecuentes (≥1/100 a <1/10) destacan la cefalea, la rubefacción o flushing y el edema. Por el contrario el edema pulmonar no consta como reacción adversa en la ficha técnica 1 , aunque sí se menciona un artículo de Packer et al, en el que se concluye que amlodipino no incrementa la morbilidad ni la mortalidad en pacientes con insuficiencia cardíaca grave y en el que se considera bajo (5%) el riesgo de edema pulmonar atribuible a amlodipino en esta población 2 . Se realizó una búsqueda mediante MEDLINE (1966( -Diciembre 2012 de artículos publicados en lengua inglesa empleando como palabras clave "amlodipine" y "pulmonar y edema" o "acute lung injury" o "heart failure". Solo se encontraron 2 casos de edema pulmonar en relación con amlodipino, en el contexto de sobredosificación el primero 3 y de envenenamiento el segundo 4 . Caso clínicoMujer de 74 años sin hábitos tóxicos y con antecedentes de hipertensión arterial, dislipemia, hipotirodisimo primario y enfermedad renal crónica de etiología no filiada (cuatro años antes presentaba: creatinina plasmática 1.4 mg/dl y filtrado glomerular estimado (FGE) 39 ml/min/1,73 m 2 obtenido por MDRD-4). Desde hacía años recibía tratamiento con telmisartán, simvastatina y levotiroxina. Un mes antes de acudir inició la toma de amlod...

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“…Noncardiogenic pulmonary edema (NCPE), a syndrome characterized by severe hypoxemia, bilateral alveolar infiltrates on chest radiograph, and no evidence of congestive heart failure, is reported as a rare complication of MTX therapy in high doses for cancer patients (6)(7)(8)(9)(10). Given that the initial differentiation between the types of MTX pneumonitis is difficult, the diagnosis of drug-induced NCPE would be an exercise of exclusion, and in most of the past reports on MTX-induced pulmonary edema, the diagnoses were made using the clinical course, radiologic findings, and in some, pathological findings (6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

Noncardiogenic Pulmonary Edema in Low-dose Oral Methotrexate Therapy

et al. 2004

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In the past two decades, low-dose methotrexate (MTX) has been widely used in the treatment of rheumatoid arthritis (RA). As adverse effects, various types of pulmonary toxicity have been reported with this therapy. We report a case of MTX-induced noncardiogenic pulmonary edema in a 35-year-old woman. MTX used in high dose for anti-cancer therapy is known to cause noncardiogenic pulmonary edema. However, there are no previous reports of noncardiogenic pulmonary edema caused by low-dose MTX therapy. This report suggests that patients receiving oral weekly, low-dose MTX may be at risk for the development of noncardiogenic pulmonary edema.

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Drug-induced Noncardiogenic Pulmonary Edema

Cited by 69 publications

References 43 publications

A case of non‐cardiogenic pulmonary edema provoked by intravenous acetazolamide

A case of non‐cardiogenic pulmonary edema provoked by intravenous acetazolamide

Edema de pulmón precipitado por amlodipino

Noncardiogenic Pulmonary Edema in Low-dose Oral Methotrexate Therapy

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