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Diphenylhydantoin-induced hepatic necrosis. A case study
Gastroenterology
|March 1, 1976
Summary
Diphenylhydantoin therapy can cause severe liver injury, including fatal hepatic necrosis, in patients with seizure disorders. Monitoring liver function is crucial to detect potential hepatocellular damage.
Area of Science:
- Neurology
- Hepatology
- Toxicology
Background:
- Post-traumatic seizure disorder management often involves anticonvulsant medications.
- Diphenylhydantoin (phenytoin) is a commonly prescribed antiepileptic drug.
- Drug-induced liver injury is a significant concern in pharmacotherapy.
Observation:
- A patient on diphenylhydantoin therapy for seizures presented with lymphadenopathy, exfoliative dermatitis, and hepatic failure.
- The patient ultimately died in hepatic coma.
- Autopsy revealed massive hepatic necrosis.
Findings:
- The clinical and pathological findings are consistent with previously reported cases of diphenylhydantoin-induced hepatic necrosis.
- A notable difference was the timing of hepatic failure onset, which was explained within the context of the case.
- The exact mechanism of diphenylhydantoin hepatotoxicity remains unknown, with hypersensitivity being a potential cause.
Implications:
- This case highlights the potential for severe, life-threatening hepatotoxicity associated with diphenylhydantoin.
- Routine liver function tests in patients receiving diphenylhydantoin are recommended to assess the incidence of hepatocellular injury.
- Further research into the mechanisms of diphenylhydantoin-induced liver injury is warranted.
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