A Severe Case of Isotretinoin Induced Eosinophilic Pneumonia and Pericardial Effusion, a Case Report

Anne Kampman; Laurien Keulers; Jan van der Maten; Jacqueline van der Meij; Carina Bethlehem

doi:10.2174/0115748863274642231121072432

A Severe Case of Isotretinoin Induced Eosinophilic Pneumonia and Pericardial Effusion, a Case Report

Curr Drug Saf. 2024 Jan 24. doi: 10.2174/0115748863274642231121072432. Online ahead of print.

Authors

Anne Kampman¹, Laurien Keulers², Jan van der Maten³, Jacqueline van der Meij⁴, Carina Bethlehem⁵

Affiliations

¹ Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
² Department of Pulmonary Medicine, Hospital Rivierenland, Tiel, The Netherlands.
³ Department of Pulmonary Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
⁴ Department of Pathology, Pathologie Friesland, Leeuwarden, The Netherlands.
⁵ Department of Intensive Care and Department of Clinical Pharmacy and Pharmacology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.

PMID: 38275048
DOI: 10.2174/0115748863274642231121072432

Abstract

Background: We report a case of a 25-year-old female who presented with fever, rash and general malaise.

Case presentation: She was initially diagnosed and treated for peri-/myocarditis, but she deteriorated quickly with the development of extensive bilateral consolidations for which she was mechanically ventilated. Two weeks before admission, she took isotretinoin for less than a week for disfiguring acne. Diagnosis of drug-induced acute eosinophilic pneumoniae (EP) was made after excluding other causes of AEP. Even before starting steroid treatment, the patient improved significantly, which was in alignment with the elimination of the active metabolite of isotretinoin.

Conclusion: The presented case underlines the importance of performing a thorough history and consider recently started drugs as the cause of eosinophilic pneumoniae, even if they have not yet been described as a known trigger of drug-induced EP.

Keywords: Care report; Drug induced eosinophilic pneumonia; Eosinophilic pneumonia; Hypersensitivity reaction; Isotretinoin; Pericardial effusion.

Publication types

Case Reports