[Humoral and cell-mediated immunities in epileptic patients (author's transl)]

Humoral and cell-mediated immunities were studied in 50 epileptic patients receiving phenytoin treatment and in 20 normals. The mean serum concentrations of IgG, IgA and IgM showed no significant difference between these two groups; however, abnormally low serum IgA (less than 125 mg/dl) was found in 10 patients (10/50, 20%) and in one of them serum IgA was less than 50 mg/dl (1/50, 2%). The serum IgA was related neither to the duration of phenytoin therapy nor to the serum concentration of the drug. The mean serum C3 value was lower in the patient group than in the normals. The mean percentages of T cells, Tmu cells, T gamma cells and monocytes were also lower in the patients, especially in those with serum level of phenytoin over 20 micrograms/ml. These data indicate that phenytoin can suppress the cell-mediated immunity, whereas certain genetic factors, in addition to the effect of phenytoin, may contribute to the change of serum immunoglobulin levels in the epileptics. The incidence of positive antinuclear antibody among the epileptics was 18%, which was much higher than that in the general population. The occurrence of autoantibody did not correlate with the serum concentration of phenytoin.