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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis

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Published on: May 10, 2024

Olanzapine-induced eosinophilic pleuritis.

Matthew Evison¹, Jayne Holme², Mohamed Alaloul²

¹North West Lung Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, M23 9LT, UK ; The Institute of Inflammation and Repair, The University of Manchester, UK.

Respiratory Medicine Case Reports

|June 2, 2015

Summary

Olanzapine, a medication for depression with psychosis, can cause eosinophilic pleuritis, a rare lung condition. Prompt diagnosis and drug withdrawal led to the patient's recovery.

Keywords:

Drug-induced pleuritis Eosinophilic pleural effusion Olanzapine Pleural effusion

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Area of Science:

Pulmonology
Pharmacology
Internal Medicine

Background:

A patient with a history of depression with psychosis presented with unexplained breathlessness and eosinophilic pleural effusion.
The patient was on olanzapine therapy for 12 months and had a family history of tuberculosis.
Eosinophilic pleural effusions necessitate a thorough diagnostic evaluation to rule out various causes.

Observation:

Computed tomography and thoracoscopy revealed bland pleural thickening without malignancy or granulomatous inflammation.
Pleural biopsies showed chronic inflammation with eosinophils but no definitive etiological markers.
Pleural fluid analysis indicated an eosinophil-rich exudative effusion.

Findings:

A diagnosis of olanzapine-induced eosinophilic pleuritis was suspected based on the clinical presentation and temporal association with medication.
Withdrawal of olanzapine resulted in the complete resolution of the pleural disease.
This case highlights olanzapine as a potential causative agent for eosinophilic pleural effusion, with only one prior report.

Implications:

Eosinophilic pleural effusions require a systematic diagnostic approach, as they are not exclusively indicative of benign conditions.
Clinicians should consider drug-induced etiologies, particularly atypical antipsychotics like olanzapine, in patients presenting with eosinophilic pleural effusions.
This case contributes to the understanding of rare adverse drug reactions and emphasizes the importance of medication review in unexplained pleural diseases.