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Clozapine Induced Eosinophilia:
Neglected Important Adverse Effect
* Eosinophilia is a non dose dependent side-effect.
* Prevalence: ~1% of clozapine-treated patients.
* Onset: 1st year of treatment, mostly in the initial 4 weeks.
* Course: transient course and spontaneous remission in most patients.
* Note: In some cases it may predict subsequent neutropenia, myocarditis, eosinophilic colitis, pancreatitis and toxic hepatitis.
(a) Interrupt Clozapine for absolute eosinophil count >4000/cu mm until the eosinophil count falls below 3000/cu mm.
(b) If there are no signs of end-organ damage or inflammation, clozapine continuation or rechallenge with careful monitoring may be considered.
(a) Indian J Psychiatry. 2015 Oct-Dec; 57(4): 429–430.
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