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Respiratory medicine
Topiramate-induced acute eosinophilic pneumonia
  1. Rahul Tyagi1,
  2. Monika Aggarwal2,
  3. Utkarsh Suyal3 and
  4. Indramani Pandey3
  1. 1Respiratory Medicine, AICTS, Pune, India
  2. 2AICTS, Pune, India
  3. 3AFMC Campus, Pune, Maharashtra, India
  1. Correspondence to Dr Rahul Tyagi; rahultyagi4960{at}gmail.com

Abstract

A man in his 40s with a known history of alcohol dependence syndrome was admitted with presenting symptoms of alcohol withdrawal. During his admission, he developed breathlessness, cough and wheezing. Investigations revealed raised absolute eosinophil count and serum IgE levels. Chest imaging showed ill-defined opacities and fibreoptic bronchoscopy with bronchoalveolar lavage confirmed eosinophilic pneumonia. Extensive workup for the cause of eosinophilia was negative. The patient’s medicines were reviewed, and it was realised that the onset of eosinophilia occurred after starting topiramate for an alcohol withdrawal seizure. The drug was stopped, leading to the complete resolution of symptoms and radiological abnormalities. This case highlights the importance of considering drug-induced causes of eosinophilic pneumonia.

  • Drugs: respiratory system
  • Interstitial lung disease

https://doi.org/10.1136/bcr-2024-261220

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: RT, US, IP and MA. The following authors gave final approval of the manuscript: RT, US, IP and MA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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