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[Acute liver failure by diphenylhydantoin].
J D Bosia1, S Borzi, D Cocozzella
1Servicio de Gastroenterología, Hospital Rodolfo Rossi de la Ciudad de La Plata.
Acta Gastroenterologica Latinoamericana
|August 5, 2000
Summary
A rare case of acute liver failure (ALF) occurred in an 18-year-old woman after taking diphenylhydantoin for seizures. This drug-induced liver injury presented without hepatic encephalopathy, a notable finding in this case.
Area of Science:
- Neurology
- Hepatology
- Pharmacology
Background:
- Diphenylhydantoin (phenytoin) is an anticonvulsant and antiarrhythmic medication.
- Acute liver failure (ALF) is a rare but serious adverse effect associated with diphenylhydantoin use.
Observation:
- An 18-year-old woman presented with generalized tonic-clonic seizures post-childbirth, attributed to an arachnoid cyst.
- She developed a mononucleosis-like illness and subsequently acute liver failure following diphenylhydantoin administration.
- Liver biopsy confirmed histological changes consistent with toxic acute liver failure.
Findings:
- This case highlights a rare instance of diphenylhydantoin-induced acute liver failure.
- A key finding was the absence of hepatic encephalopathy, which is not consistently reported in similar published cases.
- The patient's presentation mimicked infectious mononucleosis.
Implications:
- This case expands the understanding of diphenylhydantoin's potential hepatotoxicity.
- It underscores the importance of monitoring liver function in patients receiving diphenylhydantoin, especially post-partum.
- The absence of hepatic encephalopathy in this ALF case warrants further investigation in drug-induced liver injury.