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Case Reports
. 2023 Aug 31:11:2050313X231195961.
doi: 10.1177/2050313X231195961. eCollection 2023.

Clozapine-induced eosinophilia: A case report

Soumitra Das  1 , Annie Itrat  2 , Mary Elizabeth Trejo Hernandez  3 , Rasish Subedi  4 , Thusanth Jogarajah  5 , Sreshatha Vashist  6 , Nikitha Daggala  7
Affiliations
Case Reports

Clozapine-induced eosinophilia: A case report

Soumitra Das et al. SAGE Open Med Case Rep. .

Abstract

Schizophrenia is a chronic neuropsychiatric illness defined by the appearance of positive, and negative symptoms and/or cognitive impairment. Antipsychotic drugs are predominantly used in the treatment of psychotic disorders, but not all patients with schizophrenia respond to every antipsychotic medication. Clozapine is one of the best atypical antipsychotics and is highly effective in treating treatment-resistant schizophrenia. Evidence suggests that clozapine appears to be effective in lowering the risk of suicide, extrapyramidal side effects, and relapse in patients with schizophrenia. Per contra, clozapine is not the first-line treatment due to its unalterable aftereffects such as agranulocytosis, metabolic syndrome, seizures, and rarely, eosinophilia. Eosinophilia can be life-threatening. Eosinophils infiltrate different tissues and cause inflammation in multiple organs causing end-organ damage. The current study aimed to report the incidence of eosinophilia associated with clozapine use in patients with schizophrenia. Literature on clozapine-induced eosinophilia is relatively scarce. Understanding the progression and management of clozapine-induced eosinophilia and its end-organ effects is imperative. While there is insufficient data about the guidelines in the management of clozapine-induced eosinophilia, this study contributes to understanding the patterns of the disease progression with clozapine dosage. A case study was done on a patient with schizophrenia and autistic spectrum disorder who was on clozapine. Data on how eosinophil levels varied with clozapine dosing was analyzed and documented. The evidence of clozapine dosage affecting eosinophil and C-reactive protein levels in this patient was summarized in a table and a narrative review.

Keywords: Clozapine; antipsychotics; case report; eosinophilia.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Timeline of clozapine-induced eosinophilia.
Figure 2.
Figure 2.
Timeline of clozapine-induced eosinophilia (Graphical representation).
See this image and copyright information in PMC

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