title: Clozapine-induced hypersensitivity myocarditis.
abstract: A rare, but frequently fatal, side effect of the antipsychotic drug clozapine is myocarditis. We report a case of hypersensitivity myocarditis secondary to clozapine administration that was diagnosed in vivo for the first time through endomyocardial biopsy and was successfully treated with corticosteroids. Histologic diagnosis was based on the evidence of eosinophilic infiltration of the endomyocardium and eosinophil degranulation. Endomyocardial biopsy was performed in order to establish or exclude a clear-cut relationship between cardiac dysfunction and clozapine, and was crucial to establish a correct diagnosis and appropriate treatment. Clozapine withdrawal and targeted 8-day, low-dose corticosteroid therapy resolved the symptoms and restored cardiac function.
authors.affiliation: Cardiology Department, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy. biocard@rm.unicatt.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pieroni
authors.forename: Roberto
authors.initials: R
authors.lastname: Cavallaro
authors.forename: Cristina
authors.initials: C
authors.lastname: Chimenti
authors.forename: Enrico
authors.initials: E
authors.lastname: Smeraldi
authors.forename: Andrea
authors.initials: A
authors.lastname: Frustaci
mesh_terms: D003024:Clozapine / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000139:chemically induced*
chemical_list: D003024:Clozapine