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CASE REPORT
Levetiracetam-induced eosinophilic pneumonia
  1. Aisling Fagan1,
  2. Jonathan Fuld1,
  3. Elaine Soon2
  1. 1Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  2. 2Department of Medicine, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Aisling Fagan, faganai{at}tcd.ie

Summary

Levetiracetam is widely regarded as a benign antiepileptic drug, compared to older antiepileptic medication. We report a case of eosinophilic pneumonia due to levetiracetam use in a non-smoking woman aged 59 years with no previous respiratory history. Our patient presented with exertional breathlessness and marked desaturation on exertion. She displayed ‘reverse bat-wing’ infiltrates on her chest radiograph and peripheral eosinophilia on a complete blood count. Her symptoms, radiology and peripheral eosinophilia resolved completely with cessation of levetiracetam and a course of prednisolone. This is the first report of isolated eosinophilic pneumonia due to levetiracetam. Other reports of levetiracetam-induced eosinophilia describe drug rash, eosinophilia and systemic symptoms (DRESS syndrome). Detection of pulmonary drug reactions requires a careful drug history and high index of suspicion. Identifying and reporting a causative agent is crucially important, as cessation of the drug is essential for resolution of the syndrome.

https://doi.org/10.1136/bcr-2016-219121

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    Footnotes

    • Contributors JF and ES initially diagnosed and treated the patient. The decision to publish was made between all parties. AF contacted the patient for permission and wrote first draft and subsequent drafts of manuscript. JF and ES reviewed and edited all drafts before submission. Literature review was performed by AF and ES.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.