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Related Experiment Videos

Immune function in patients treated with phenytoin.

A W Burks1, R Charlton, P Casey

  • 1Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock 72202.

Journal of Child Neurology
|January 1, 1989
PubMed
Summary
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Phenytoin use may be linked to immunologic issues, but this study found low immunoglobulin A (IgA) levels are not common in patients. Routine IgA monitoring for phenytoin users offers limited clinical value.

Area of Science:

  • Immunology
  • Pharmacology
  • Clinical Medicine

Background:

  • Phenytoin is associated with various immunologic side effects.
  • Previous studies suggest potential cellular and humoral abnormalities in patients taking phenytoin.
  • A reduction in serum immunoglobulin A (IgA) is the most frequently reported finding, affecting up to 20% of patients.

Purpose of the Study:

  • To investigate the incidence of reduced serum IgA in patients taking phenytoin.
  • To evaluate the cellular immune status of patients with low IgA levels.
  • To determine the clinical significance of IgA reduction in phenytoin users.

Main Methods:

  • 191 patients on phenytoin were assessed for serum IgA levels.
  • Patients with IgA values below two standard deviations from the mean underwent further immune studies.

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  • Evaluated parameters included total lymphocyte counts, lymphocyte populations, and in vitro mitogen stimulation responses.

    • Main Results:

    • Only 2 out of 191 patients (1.05%) had serum IgA levels below 5 mg/dL, which is not statistically different from the general population.
    • Patients with decreased IgA did not show a higher incidence of autoimmune diseases, allergies, gastrointestinal issues, or recurrent infections.
    • Cellular immune status in these patients was comparable to control groups.

    Conclusions:

    • Routine monitoring of serum IgA in patients taking phenytoin has limited clinical utility.
    • The immunologic side effects of phenytoin do not appear to manifest as significant cellular immune abnormalities.
    • The observed low incidence of IgA reduction suggests it is not a reliable indicator of adverse immunologic effects in most phenytoin users.