Eosinophilic pleural effusion due to dantrolene: resolution with steroid therapy.
A quadriplegic patient with severe spasticity, treated with dantrolene (400 mg daily) for 5 years, had dyspnea, orthopnea, hypoxia, and right-sided opacity of the chest on radiograph. At thoracentesis, an exudative effusion containing 64% eosinophils was documented, with simultaneous peripheral eosinophilia of 11%. An allergic reaction to dantrolene was postulated. Despite withdrawal of the offending medication and repeated thoracenteses, symptomatic recurrence of effusion persisted for 4 days. After institution of prednisone therapy, rapid resolution of symptoms, signs, hypoxia, and radiologic abnormalities was observed. In contrast to five previously reported cases of dantrolene-associated eosinophilic pleural effusion (EPE), ours represents the first in which the patient was treated with steroids and suggests that steroid therapy may be of benefit in drug-related EPE.
Felz
M W
MW
Department of Family Medicine, Medical College of Georgia, Augusta 30912, USA.
Haviland-Foley
D J
DJ
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003620:Dantrolene / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004802:Eosinophilia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D009125:Muscle Relaxants, Central / Q000009:adverse effects*; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D010996:Pleural Effusion / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D011782:Quadriplegia / Q000150:complications
D000893:Anti-Inflammatory Agents; D009125:Muscle Relaxants, Central; D003620:Dantrolene; D011241:Prednisone