title: Levetiracetam-induced eosinophilic pneumonia.
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: Aisling
authors.initials: A
authors.lastname: Fagan
authors.affiliation: Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fuld
authors.affiliation: Department of Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Soon
mesh_terms: D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008875:Middle Aged; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives*; D011239:Prednisolone / Q000627:therapeutic use; D011657:Pulmonary Eosinophilia / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000077287:Levetiracetam; D011239:Prednisolone; D010889:Piracetam