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Related Experiment Videos

Cholestatic liver dysfunction after long-term phenytoin therapy.

J W Taylor, M N Stein, M J Murphy

    Archives of Neurology
    |May 1, 1984
    PubMed
    Summary

    Long-term phenytoin sodium use can cause cholestatic jaundice, a liver condition. Stopping the drug resolved symptoms, and restarting it caused them to return, confirming phenytoin as the cause.

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    Area of Science:

    • Hepatology
    • Clinical Pharmacology
    • Drug-Induced Liver Injury

    Background:

    • Phenytoin sodium, an anticonvulsant medication, has been associated with various adverse drug reactions.
    • Prolonged use of certain medications can lead to idiosyncratic hepatic responses.
    • Cholestatic jaundice is characterized by impaired bile flow, leading to bilirubin accumulation.

    Observation:

    • A 64-year-old woman developed cholestatic jaundice after more than 40 years of phenytoin sodium therapy.
    • Hepatic abnormalities resolved upon discontinuation of phenytoin.
    • Symptoms recurred upon rechallenge with phenytoin, establishing a causal link.

    Findings:

    • Liver biopsy revealed cholestasis, suggesting biliary obstruction, though no obstructive cause was found.
    • Biochemical and histological findings indicated an unusual reaction to phenytoin.
    • The case highlights a rare, drug-induced cholestatic pattern potentially mimicking biliary obstruction.

    Implications:

    • This case underscores the importance of considering drug-induced liver injury in patients with unexplained cholestasis.
    • Physicians should be vigilant for rare adverse reactions even after long-term medication use.
    • Discontinuation and rechallenge remain crucial diagnostic steps for suspected drug-induced hepatotoxicity.

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