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[Phenytoin hypersensitivity syndrome]
J García-Samaniego1, V Soriano, J Soto
1Servicio de Gastroenterología, Instituto de Salud Carlos III, Madrid.
Anales De Medicina Interna (Madrid, Spain : 1984)
|November 1, 1994
Summary
Diphenylhydantoin (DPH) hypersensitivity can cause severe systemic reactions, including hepatitis and dermatitis. Prompt steroid therapy led to complete recovery in a patient with DPH-induced hypersensitivity syndrome.
Area of Science:
- Pharmacology
- Toxicology
- Dermatology
Background:
- Diphenylhydantoin (phenytoin) is a widely used antiepileptic drug.
- Rarely, it can induce a severe, multisystemic hypersensitivity reaction.
- This reaction typically manifests 4-8 weeks after treatment initiation.
Observation:
- The case involved a patient presenting with fever, lymphadenopathy, hepatitis, eosinophilia, and a desquamative cutaneous eruption.
- The patient exhibited mononucleosis-like symptoms, icteric hepatitis, and exfoliative dermatitis.
- These symptoms are characteristic of a severe hypersensitivity response to diphenylhydantoin.
Findings:
- The patient experienced a severe hypersensitivity syndrome attributed to diphenylhydantoin.
- Despite the potential for high mortality, especially with severe hepatic involvement, the patient showed a positive response to treatment.
- Complete recovery was achieved within days of hospitalization, suggesting the efficacy of timely intervention.
Implications:
- This case highlights the importance of recognizing diphenylhydantoin hypersensitivity syndrome.
- Early diagnosis and prompt treatment, including steroid therapy, are crucial for favorable outcomes.
- Physicians should maintain a high index of suspicion for this adverse drug reaction in patients on diphenylhydantoin therapy.