Since the first case report by Steinberg in 1968, more than 50 cases of acute noncardiogenic pulmonary edema caused by hydrochlorothiazide (HCT) have been reported (1).Most cases have an acute onset of symp- toms and rapid improvement with support-ive treatment. The reaction developed either upon taking HCT for the first time or after having taken the drug previously without reaction. The majority of cases have a positive challenge test with HCT and tolerate furose-mide (1). Some cases reveal transient leucopenia (2) and/or thrombopenia, likely because of pulmonary sequestration of neutrophils (3); however, blood eosinophils and total IgE tend to fall within normal values. When measured, specific IgE or IgG to HCT has been negative (4).
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