Olanzapine-Induced Systemic Lupus Erythematosus: A Case Report
Abstract:
Olanzapine is a widely prescribed atypical antipsychotic, generally considered safe regarding hematological adverse effects compared to other antipsychotics. We report the case of a 19-year-old female treated for depression with fluoxetine 20 mg, who developed a clinical and biological picture suggestive of drug-induced systemic lupus erythematosus (SLE) following the introduction of olanzapine 5 mg for delusional symptoms. Thirty days after starting olanzapine, the patient presented with prolonged fever, fatigue, anorexia, polyarthralgia, and a scaly skin rash. Laboratory tests revealed anemia (hemoglobin 9 g/dL), severe leukopenia (1000/mm³), and positive antinuclear antibodies, while other specific antibodies remained negative. This case highlights the importance of considering drug-induced SLE in the presence of systemic manifestations in patients treated with olanzapine, even in the absence of classic specific SLE antibodies.
KeyWords:
Olanzapine, Drug-induced lupus erythematosus, atypical antipsychotics
References:
- Yaseen K. Systemic lupus erythematosus. MSD Manuals Professional Edition. 2024.
- Chang C, Gershwin ME. Drug-induced lupus erythematosus: incidence, management and prevention. Drug Saf. 2023;34(5):357-374.
- Cleynen I, Goyvaerts A, De Rijcke L, et al. Side effects of antipsychotic medications: hematologic effects and drug-induced autoimmunity. CNS Drugs. 2022;36(8):673-688.
- Sarkar P, Aga P, Banerjee A. The Association of Psychiatric Medications and Systemic Lupus Erythematosus: A Comprehensive Review. Cureus. 2024;13(2):e13572.
- Antonov D, Kazandjieva J, Etugov D, Gospodinov D, Tsankov N. Drug-induced lupus erythematosus. Clin Dermatol. 2022;30(2):195-201.
- Jain R, Thakkar N, Feldman G. Olanzapine-induced agranulocytosis in systemic lupus erythematosus. Pharmacotherapy. 2006;26(10):1511-1513.