Diphenylhydantoin-induced lymphocytic interstitial pneumonia

Area of Science:

• Pulmonology
• Pharmacology
• Pathology

Background:

• Drug-induced lung injury is a recognized complication of various medications.
• Phenytoin (diphenylhydantoin) is an anticonvulsant medication with potential adverse effects.

Observation:

• A patient receiving long-term diphenylhydantoin therapy for 14 months developed diffuse lymphocytic interstitial pneumonia.
• The patient presented with symptoms indicative of interstitial lung disease.

Findings:

• Combined transbronchial biopsy and bronchoalveolar lavage (BAL) were crucial in diagnosing the condition.
• Discontinuation of diphenylhydantoin therapy led to a significant reversal of the observed lung pathology.

Implications:

• This case underscores the importance of considering drug-induced lung disease in patients on diphenylhydantoin.
• Serial bronchoalveolar lavage is a valuable tool for monitoring the progression and resolution of drug-induced interstitial pneumonia.