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Diltiazem-induced eosinophilic pleural effusion
Lampros Raptis1, Georgios Pappas, Andromahi Katsanou
1Department of Internal Medicine, General Hospital G. Hatzikosta, Ioannina, Greece.
Pharmacotherapy
|March 27, 2007
Summary
Diltiazem, an antihypertensive drug, may cause eosinophilic pleural effusion and systemic eosinophilia. This is the first reported case, highlighting that drug-induced eosinophilia may be more common than previously recognized.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Drug-induced hypersensitivity reactions can manifest with diverse clinical presentations.
- Eosinophilic pleural effusion (EPE) and systemic eosinophilia are rare but serious adverse drug reactions.
- Several medications are implicated in EPE, necessitating careful diagnostic evaluation.
Observation:
- A 68-year-old woman presented with EPE and eosinophilia after initiating diltiazem therapy.
- Other potential causes, including malignancy, infection, and autoimmune disorders, were ruled out.
- Symptoms resolved upon diltiazem discontinuation, with no recurrence.
Findings:
- This case report is the first to link diltiazem to EPE and systemic eosinophilia.
- The Naranjo scale indicated a probable association between diltiazem and the patient's condition.
- The findings suggest diltiazem as a potential, previously unrecognized cause of EPE.
Implications:
- The spectrum of drugs causing eosinophilia and EPE may be broader than currently recognized.
- Clinicians should consider diltiazem in the differential diagnosis of patients presenting with unexplained EPE and eosinophilia.
- This case underscores the importance of comprehensive drug history and causality assessment in adverse drug reaction evaluations.
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