Pancytopenie en drug fever bij olanzapine

Olanzapine-induced pancytopenia and drug fever Olanzapine is a frequently used antipsychotic. Despite the structural similarity, olanzapine is considered a safer alternative for clozapine in terms of side effects. Hematological suppression, particularly neutropenia, is generally not associated with olanzapine. Furthermore, fever in the absence of a malignant neuroleptic syndrome is not an expected side effect of olanzapine. This case reports the occurrence of olanzapine-induced pancytopenia and fever in a 74-year-old woman with acute psychosis. Both side effects developed a few days after starting olanzapine and resolved after its discontinuation. Extensive investigations did not reveal any satisfactory alternative explanation for both phenomena. This article describes other cases with similar findings and discusses the possible pathogenesis. This case, in addition to other case reports, suggests that olanzapine can also lead to hematological suppression. Whether hematological monitoring, as with clozapine, is required, needs further investigation. Furthermore, this case illustrates that fever can occur with olanzapine in the absence of a malignant neuroleptic syndrome. Increased vigilance for both side effects is therefore indicated.