A case of drug-induced interstitial pneumonia potentially related to quetiapine (seroquel) therapy for behavioral and psychological symptoms

Respir Care. 2014 Oct;59(10):e145-8. doi: 10.4187/respcare.02977. Epub 2014 Apr 29.

Abstract

Quetiapine is regarded as an effective and safe treatment for delirium. An 82-year-old man presented with a 1-week history of violent behavior and dizziness accompanied by weakness on the left side of his body. He was diagnosed with acute cerebral cortical infarction and delirium associated with alcohol abuse. After quetiapine treatment, he complained of fever and coughed up sputum, whereas his aggressive behavior improved. His symptoms persisted despite empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. High-resolution computed tomography revealed bilateral consolidations and ground-glass opacities with predominantly peribronchial and subpleural distributions. The primary differential diagnosis was drug-associated interstitial lung disease, and therefore, we discontinued quetiapine and began methylprednisolone treatment. His symptoms and radiologic findings significantly improved after receiving steroid therapy. We propose that clinicians need to be aware of the possibility that quetiapine is associated with lung injury.

Keywords: alcohol abuse; interstitial pneumonia; quetiapine.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antipsychotic Agents / adverse effects*
  • Delirium / drug therapy*
  • Diagnosis, Differential
  • Dibenzothiazepines / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Lung Diseases, Interstitial / chemically induced*
  • Lung Diseases, Interstitial / drug therapy
  • Male
  • Methylprednisolone / therapeutic use
  • Psychomotor Agitation / drug therapy*
  • Quetiapine Fumarate
  • Tomography, X-Ray Computed

Substances

  • Antipsychotic Agents
  • Dibenzothiazepines
  • Glucocorticoids
  • Quetiapine Fumarate
  • Methylprednisolone