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Olanzapine-induced eosinophilic pleuritis.

Evison M, Holme J, Alaloul M, Doran H, Bishop P, Booton R, Chaudhry N - Respir Med Case Rep (2014)

Bottom Line: Pleural tissue culture did not yield mycobacteria.A diagnosis of olanzapine-induced eosinophilic pleuritis was suspected and the pleural disease resolved with withdrawal of olanzapine.This is the second case report to identify olanzapine as a causative agent in eosinophilic pleural effusion.

View Article: PubMed Central - PubMed

Affiliation: North 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.

ABSTRACT
An elderly patient, with a history of depression with psychosis, presented with breathlessness, a right exudative pleural effusion and a peripheral eosinophilia. The pleural fluid was eosinophil-rich (10% of leucocytes). Olanzapine therapy had been commenced 12 months previously. There was a family history of TB and the patient was of African origin. A full diagnostic work-up ensued including computed tomography of the thorax and local anaesthetic thoracoscopy. The pleura was unremarkable on CT and displayed bland smooth thickening at visual inspection during thoracoscopy. Pleural biopsies demonstrated chronic inflammation with eosinophils but no evidence of granulomatous inflammation or malignancy. Pleural tissue culture did not yield mycobacteria. A diagnosis of olanzapine-induced eosinophilic pleuritis was suspected and the pleural disease resolved with withdrawal of olanzapine. Eosinophilic pleural fluid is not a marker of non-malignant aetiology and eosinophilic pleural effusions require a careful and systematic diagnostic work-up. This is the second case report to identify olanzapine as a causative agent in eosinophilic pleural effusion.

No MeSH data available.


Related in: MedlinePlus

Papanicolaou stained cytospin demonstrating eosinophil-rich pleural fluid (cells with bi-lobed nuclei with brown granules). An eosinophilic effusion is defined as ≥10% eosinophils. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
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fig3: Papanicolaou stained cytospin demonstrating eosinophil-rich pleural fluid (cells with bi-lobed nuclei with brown granules). An eosinophilic effusion is defined as ≥10% eosinophils. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)


Olanzapine-induced eosinophilic pleuritis.

Evison M, Holme J, Alaloul M, Doran H, Bishop P, Booton R, Chaudhry N - Respir Med Case Rep (2014)

Papanicolaou stained cytospin demonstrating eosinophil-rich pleural fluid (cells with bi-lobed nuclei with brown granules). An eosinophilic effusion is defined as ≥10% eosinophils. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356047&req=5

fig3: Papanicolaou stained cytospin demonstrating eosinophil-rich pleural fluid (cells with bi-lobed nuclei with brown granules). An eosinophilic effusion is defined as ≥10% eosinophils. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Bottom Line: Pleural tissue culture did not yield mycobacteria.A diagnosis of olanzapine-induced eosinophilic pleuritis was suspected and the pleural disease resolved with withdrawal of olanzapine.This is the second case report to identify olanzapine as a causative agent in eosinophilic pleural effusion.

View Article: PubMed Central - PubMed

Affiliation: North 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.

ABSTRACT
An elderly patient, with a history of depression with psychosis, presented with breathlessness, a right exudative pleural effusion and a peripheral eosinophilia. The pleural fluid was eosinophil-rich (10% of leucocytes). Olanzapine therapy had been commenced 12 months previously. There was a family history of TB and the patient was of African origin. A full diagnostic work-up ensued including computed tomography of the thorax and local anaesthetic thoracoscopy. The pleura was unremarkable on CT and displayed bland smooth thickening at visual inspection during thoracoscopy. Pleural biopsies demonstrated chronic inflammation with eosinophils but no evidence of granulomatous inflammation or malignancy. Pleural tissue culture did not yield mycobacteria. A diagnosis of olanzapine-induced eosinophilic pleuritis was suspected and the pleural disease resolved with withdrawal of olanzapine. Eosinophilic pleural fluid is not a marker of non-malignant aetiology and eosinophilic pleural effusions require a careful and systematic diagnostic work-up. This is the second case report to identify olanzapine as a causative agent in eosinophilic pleural effusion.

No MeSH data available.


Related in: MedlinePlus