Diagnostically Confusing Complications of Diphenylhydantoin Therapy
Authors: MARSHALL SPARBERG
Journal: Annals of Internal Medicine (1963)

Review1 December 1963Diagnostically Confusing Complications of Diphenylhydantoin TherapyA ReviewMARSHALL SPARBERG, M.D.MARSHALL SPARBERG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-59-6-914 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDiphenylhydantoin (DPH) (Dilantin®) has been widely used in the therapy of grand mal and psychomotor epilepsy since 1938 (1). The common complications were recognized early (2, 3). Cerebellar incoordination is the most frequent neurologic complication, but other diagnostically confusing neurologic lesions may occur, such as hemiplegia (4), extraocular palsy (5), and meningeal irritation with pleocytosis and elevated protein in the cerebrospinal fluid (6). Gingival hyperplasia, due to excessive deposition of collagen, has been observed in 6 to 62 per cent of patients receiving DPH (7). Nausea and abdominal pain may result from the chemical irritation of the alkaline salt. Dermatitis,...References1. MERRITTPUTNAM HHTJ: Sodium diphenyl hydantoinate in the treatment of convulsive disorders. JAMA 111: 1068, 1938. CrossrefGoogle Scholar2. MERRITTPUTNAM HHTJ: Sodium diphenyl hydantoinate in treatment of convulsive seizures. Toxic symptoms and their prevention. Arch. Neurol. Psychiat. (Chicago) 42: 1053, 1939. CrossrefGoogle Scholar3. KIMBALL OP: The treatment of epilepsy with sodium diphenyl hydantoinate. JAMA 112: 1244, 1939. CrossrefGoogle Scholar4. MORRISFISCHERBERGIN JVEJT: Rare complications of phenytoin sodium treatment. Brit. Med. J. 2: 1529, 1956. CrossrefMedlineGoogle Scholar5. MANLAPAZ JS: Abducens nerve palsy in Dilantin intoxication. J. Pediat. 55: 73, 1959. CrossrefMedlineGoogle Scholar6. DUTTON P: Phenytoin toxicity with associated meningeal reaction. J. Ment. Sci. 104: 1165, 1958. CrossrefMedlineGoogle Scholar7. GOODMANGILMAN LSA: The Pharmacologic Basis of Therapeutics, 2nd Ed., The Macmillan Company, New York, 1956, p. 181. Google Scholar8. CLEVELAND R: Convulsive Disorders, with Particular Reference to Treatment with Dilantin Sodium in the United States and Great Britain. Parke, Davis and Company, 1945. Google Scholar9. BRAY PF: Diphenylhydantoin (Dilantin) after 20 years. A review with re-emphasis by treatment of 84 patients. Pediatrics 23: 151, 1959. MedlineGoogle Scholar10. DILLKAZENKOWOLFGLAZKO WAALMAJ: Studies on 5, 5-diphenylhydantoin (Dilantin) in animals and man. J. Pharm. Exp. Ther. 118: 270, 1956. MedlineGoogle Scholar11. SVENSMARKSCHILLERBUCHTHAL OPJF: 5, 5-diphenylhydantoin (Dilantin) blood levels after oral or intravenous dosage in man. Acta Pharmacol. (København) 16: 331, 1960. CrossrefMedlineGoogle Scholar12. SWINYARDWEAVERGOODMAN EALCLS: Effect of liver injury and nephrectomy on the anticonvulsant activity of clinically useful hydantoins. J. Pharm. Exp. Ther. 104: 309, 1952. MedlineGoogle Scholar13. BUTLER TC: The metabolic conversion of 5, 5-diphenyl hydantoin to 5-(hydroxyphenyl)-5-phenyl hydantoin. J. Pharm. Exp. Ther. 119: 1, 1957. MedlineGoogle Scholar14. MAYNERT EW: The metabolic fate of diphenylhydantoin in the dog, rat and man. J. Pharm. Exp. Ther. 130: 275, 1960. MedlineGoogle Scholar15. NOACHWOODBURYGOODMAN ELDMLS: Studies on the absorption distribution, fate and excretion of 4-C14-labeled diphenylhydantoin. J. Pharm. Exp. Ther. 122: 301, 1958. MedlineGoogle Scholar16. WOODBURY DM: Effect of diphenylhydantoin on electrolytes and radiosodium turnover in brain and other tissues of normal, hyponatremic and postictal rats. J. Pharm. Exp. Ther. 115: 74, 1955. MedlineGoogle Scholar17. WOODBURYKOCHVERNADAKIS DMAA: Relation between excitability and metabolism in brain as elicited by anticonvulsant drugs. Neurology 8 (Suppl 1): 113, 1958. CrossrefMedlineGoogle Scholar18. WOODBURY DM: Effects of chronic administration of anticonvulsant drugs, alone and in combination with desoxycorticosterone, on electroshock seizure threshold and tissue electrolytes. J. Pharm. Exp. Ther. 105: 46, 1952. MedlineGoogle Scholar19. ROHRBACK P: Knochenmarksschädigung und Panhämocytopenie durch Hydantoin körper. Schweiz. Med. Wschr. 80: 337, 1950. Google Scholar20. HAWKINGSMEYNELL CFMJ: Megaloblastic anemia due to phenytoin sodium. Lancet 2: 737, 1954. CrossrefGoogle Scholar21. WEBSTER JM: Megaloblastic anemia due to phenytoin sodium. Lancet 2: 1017, 1954. CrossrefGoogle Scholar22. GYDELL K: Megaloblastic anemia in patients treated with diphenylhydantoin and primidone. Acta Haemat (Basel) 17: 1, 1957. CrossrefMedlineGoogle Scholar23. LEES F: Radioactive vitamin B12 absorption in megaloblastic anemia caused by anticonvulsant drugs. Quart. J. Med. 30: 231, 1961. MedlineGoogle Scholar24. BADENOCH J: The use of labeled vitamin B12 and gastric biopsy in the investigation of anemia. Proc. Roy. Soc. Med. 47: 426, 1954. MedlineGoogle Scholar25. RHINDVARADI EGS: Megaloblastic anemia due to phenytoin sodium. Lancet 2: 921, 1954. CrossrefGoogle Scholar26. RYANFORSHAW GMJW: Megaloblastic anemia due to phenytoin sodium. Brit. Med. J. 2: 242, 1955. CrossrefMedlineGoogle Scholar27. VAISHNAVA H: Anemia following anticonvulsants. Brit. Med. J. 2: 791, 1955. CrossrefGoogle Scholar28. BERLYNELEVENEMCGLASHAN NMA: Megaloblastic anemia following anticonvulsants. Brit. Med. J. 1: 1247, 1955. CrossrefMedlineGoogle Scholar29. HURWITZ LJ: Spontaneous hypoparathyroidism with megaloblastic anemia. Lancet 1: 234, 1956. CrossrefGoogle Scholar30. NELSONBISHOP NARC: Nonaddisonian megaloblastic anemia. Clin. Res. Proc. 4: 234, 1956. Google Scholar31. BARKER JC: Megaloblastic anemia during anticonvulsant therapy. Lancet 2: 747, 1957. CrossrefGoogle Scholar32. KIDDMOLLIN PDL: Megaloblastic anemia and vitamin B12 deficiency after anticonvulsant therapy. Brit. Med. J. 2: 974, 1957. CrossrefMedlineGoogle Scholar33. FORSHAW JW: Megaloblastic anemia with anticonvulsant therapy. Postgrad. Med. J. 33: 242, 1957. CrossrefMedlineGoogle Scholar34. BENIANSHUNTER RCRA: Megaloblastic anemia occurring during treatment of epilepsy with phenytoin sodium, primidone and phenobarbitone. J. Ment. Sci. 103: 606, 1957. CrossrefMedlineGoogle Scholar35. HAWKINGSMEYNELL CFMJ: Macrocytosis and macrocytic anemia caused by anticonvulsant drugs. Quart. J. Med. 27: 45, 1958. MedlineGoogle Scholar36. WILKINSON T: Megaloblastic anemia during antiepileptic therapy. Med. J. Aust. 2: 894, 1959. CrossrefGoogle Scholar37. FLEXNERHARTMAN JMRC: Megaloblastic anemia associated with anticonvulsant drugs. Amer. J. Med. 28: 386, 1960. CrossrefMedlineGoogle Scholar38. MACINTOSHHUTCHINSON PCJL: Megaloblastic anemia due to anticonvulsant therapy. Report of a case responding to vitamin B12. Canad. Med. Ass. J. 82: 365, 1960. MedlineGoogle Scholar39. SHERWINWAITCOOPER ALRHBA: Megaloblastic anemia associated with phenobarbital therapy. Ibid. 368. Google Scholar40. LUSTBERGGOLDMANDRESKIN ADOH: Megaloblastic anemia due to Dilantin therapy. Ann. Intern. Med. 54: 153, 1961. LinkGoogle Scholar41. DRUSKINWALLENBONGURA MSMHL: Anticonvulsant-associated megaloblastic anemia. New Eng. J. Med. 267: 483, 1962. CrossrefMedlineGoogle Scholar42. : Semi-Annual Tabulation of Reports Submitted to the Study Group on Blood Dyscrasias 6 (no. 2): 10 & 31, 1962. Google Scholar43. GIRDWOODLENMAN RHJA: Megaloblastic anemia occurring during primidone therapy. Brit. Med. J. 1: 146, 1956. CrossrefMedlineGoogle Scholar44. NEWMANSUMNER MJDW: Megaloblastic anemia following the use of primidone. Blood 12: 183, 1957. CrossrefMedlineGoogle Scholar45. CHRISTENSONULTMANNROSEMAN WNJEDM: Megaloblastic anemia during primidone (Mysoline) therapy. JAMA 163: 940, 1957. CrossrefMedlineGoogle Scholar46. CHANARINELMESMOLLIN IPCDL: Folic-acid studies in megaloblastic anemia due to primidone. Brit. Med. J. 2: 80, 1958. CrossrefMedlineGoogle Scholar47. HOBSONSELWYNMOLLIN QJJGDL: Megaloblastic anemia due to barbiturates. Lancet 2: 1079, 1956. CrossrefGoogle Scholar48. HAWKINSMEYNELL CFMJ: Megaloblastic anemia during anticonvulsant therapy. Lancet 2: 846, 1957. CrossrefGoogle Scholar49. CALVERTHURWORTHMACBEAN RJEAL: Megaloblastic anemia from methophenobarbital. Blood 13: 894, 1958. CrossrefMedlineGoogle Scholar50. BECK WS: The metabolic functions of vitamin B12. New Eng. J. Med. 266: 814, 1962. CrossrefMedlineGoogle Scholar51. CHANARINMOLLINANDERSON IDLBB: Folic acid deficiency and megaloblastic anemias. Proc. Roy. Soc. Med. 51: 757, 1958. CrossrefMedlineGoogle Scholar52. CHANARIN I: Cited by Christenson, Ultmann, and Roseman (45). Google Scholar53. BROQUIST HP: Cited by Forshaw (33). Google Scholar54. ZALUSKYHERBERTCASTLE RVWB: Cyanocobalamin therapy effect in folic acid deficiency. Arch. Intern. Med. (Chicago) 109: 545, 1962. CrossrefMedlineGoogle Scholar55. ARINGROSENBAUM CDM: Ingestion of large doses of Dilantin sodium. Arch. Neurol. Psychiat. (Chicago) 45: 265, 1941. CrossrefGoogle Scholar56. DICKERSON WW: The present status of Dilantin therapy. Amer. J. Psychiat. 98: 515, 1942. CrossrefGoogle Scholar57. RIOCHMOORE DCV: Personal communication. Cited by Cleveland (8). Google Scholar58. SCHOEMPERLEN CB: Agranulocytosis due to Dilantin sodium. Manitoba Med. Rev. 27: 687, 1947. MedlineGoogle Scholar59. MIDDLETONHEJTMANCIK JWMR: Severe leukopenia due to diphenylhydantoin sodium. Texas J. Med. 46: 520, 1950. MedlineGoogle Scholar60. TURNER P: Granulocytopenia after treatment with phenytoin sodium. Brit. Med. J. 1: 1790, 1960. CrossrefMedlineGoogle Scholar61. HELLERSLOANE GM: Erythema bullosum malignans following Dilantin therapy. Pediatrics 5: 836, 1950. MedlineGoogle Scholar62. SLAVINBROUN RGGO: Agranulocytosis after diphenylhydantoin and chlorothiazide therapy. Arch. Intern. Med. (Chicago) 108: 940, 1961. CrossrefMedlineGoogle Scholar63. KURTZKE JF: Leukopenia with diphenylhydantoin. J. Nerv. Ment. Dis. 132: 339, 1961. CrossrefMedlineGoogle Scholar64. WINTROBE MM: Clinical Hematology, 5th Ed., Lea & Febiger, Philadelphia, 1961, p. 556. Google Scholar65. HAWKINSMEYNELL CFMJ: Macrocytosis and megaloblastic anemia in epileptics on anticonvulsant drugs. Quart. J. Med. 25: 567, 1956. Google Scholar66. BRITTINGHAM T: Personal communication. Google Scholar67. PAOLETTI G: Sulla porpora thrombocitopenica da "anticorpi allergici." Minerva Med. 48: 3883, 1957. MedlineGoogle Scholar68. WEINTRAUBPECHETALEXANDER RMLB: Rapid diagnosis of drug-induced thrombocytopenic purpura. JAMA 180: 528, 1962. CrossrefMedlineGoogle Scholar69. SALTZSTEINACKERMAN SLLV: Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically and pathologically malignant lymphomas. Cancer 12: 164, 1959. CrossrefMedlineGoogle Scholar70. ROSENFELDSWILLERSHENOYMORRISON SIYMAN: Syndrome simulating lymphosarcoma induced by diphenylhydantoin sodium. JAMA 176: 491, 1961. CrossrefMedlineGoogle Scholar71. SIEGALBERKOWITZ SJ: Diphenylhydantoin (Dilantin) hypersensitivity with infectious mononucleosis-like syndrome and jaundice. J. Allerg. 32: 447, 1961. CrossrefGoogle Scholar72. BAJOGHLI M: Generalized lymphadenopathy and hepatosplenomegaly induced by diphenylhydantoin. Pediatrics 28: 943, 1961. CrossrefMedlineGoogle Scholar73. CHAIKENGOLDBERGSEGAL BHBIJP: Dilantin sensitivity. Report of a case of hepatitis with jaundice, pyrexia and exfoliative dermatitis. New Eng. J. Med. 242: 897, 1950. CrossrefMedlineGoogle Scholar74. GROPPER AL: Diphenylhydantoin sensitivity. Report of fatal case with hepatitis and exfoliative dermatitis. New Eng. J. Med. 254: 522, 1956. CrossrefMedlineGoogle Scholar75. MANDELBAUMKANE HLJ: Dilatin sodium poisoning. Arch. Neurol. Psychiat. (Chicago) 45: 769, 1941. CrossrefGoogle Scholar76. CLINICOPATHOLOGIC CONFERENCE: Lymphoma or drug reaction occurring during hydantoin therapy for epilepsy. Amer. J. Med. 32: 286, 1962. CrossrefGoogle Scholar77. MELLERRESCH RLJA: Convulsive disorders in adults. Postgrad. Med. 6: 452, 1949. CrossrefMedlineGoogle Scholar78. OPPENHEIMERFISHERNELSONJAILER JHLVKMJW: Depression of the serum protein-bound iodine level by diphenylhydatoin. J. Clin. Endocr. 21: 252, 1961. CrossrefMedlineGoogle Scholar79. OPPENHEIMERTAVERNETTI JHRR: Displacement of thyroxine from human thyroxine-binding globulin by analogues of hydantoin. Steric aspects of the thyroxine-binding site. J. Clin. Invest. 41: 2213, 1962. CrossrefMedlineGoogle Scholar80. OPPENHEIMERTAVERNETTI JHRR: Studies on the thyroxine-diphenylhydantoin interaction. Effect of 5, 5-diphenylhydantoin on the displacement of l-thyroxine from thyroxine-binding globulin (TBG). Endocrinology 71: 496, 1962. CrossrefMedlineGoogle Scholar81. WOLFFSTANDAERTRALL JMEJE: Thyroxine displacement from serum proteins and depression of serum protein-bound iodine by certain drugs. J. Clin. Invest. 40: 1373, 1961. CrossrefMedlineGoogle Scholar82. EMMETTHARTZLERBROWN ADERRA: The effect of sodium diphenyl hydantoinate (Dilantin sodium) on the utilization of ascorbic acid by guinea pigs. J. Pharm. Exp. Ther. 78: 215, 1943. Google Scholar83. BONNYCASTLEBRADLEY DDAJ: Diphenylhydantoin and the release of ACTH in the albino rat. Endocrinology 66: 355, 1960. CrossrefMedlineGoogle Scholar84. STAPLE PH: The effects of continued administration of 5, 5-diphenylhydantoin ("Dilantin") sodium on the adrenal glands in mice. J. Roy. Micr. Soc. 74: 10, 1954. CrossrefMedlineGoogle Scholar85. COSTAGLASERBONNYCASTLE PJGHDD: Effects of diphenylhydantoin (Dilantin) on adrenal cortical function. Arch. Neurol. Psychiat. (Chicago) 74: 88, 1955. CrossrefMedlineGoogle Scholar86. KRIEGER DT: Effect of diphenylhydantoin on pituitary-adrenal interrelations. J. Clin. Endocr. 22: 490, 1962. CrossrefGoogle Scholar87. KIPNIS DM: Personal communication. Google Scholar88. BRAYELYKELLEY PFRSVC: Studies of 17-hydroxycorticosteroids. VIII. Adreno-cortical function in patients with convulsive disorders. Arch. Neurol. Psychiat. (Chicago) 72: 583, 1954. CrossrefMedlineGoogle Scholar89. CHRISTYHOFMANN NPAD: Effects of diphenylhydantoin upon adrenal cortical function in man. Neurology 9: 245, 1959. CrossrefMedlineGoogle Scholar90. LIVINGSTONPETERSENBOKS SDLL: Hypertrichosis occurring in association with Dilantin therapy. J. Pediat. 47: 351, 1955. CrossrefMedlineGoogle Scholar91. LIVINGSTON S: Treatment of epilepsy with diphenylhydantoin sodium (Dilantin sodium). Postgrad. Med. 20: 584, 1956. CrossrefMedlineGoogle Scholar92. MOORE MT: Pulmonary changes in hydantoin therapy. JAMA 171: 1328, 1959. CrossrefMedlineGoogle Scholar93. LOWYAHR NLMD: The lack of pulmonary fibrosis in patients receiving diphenylhydantoin. JAMA 174: 1201, 1960. CrossrefMedlineGoogle Scholar94. LIVINGSTONWHITEHOUSEPAULI SDLL: Study of the effects of Dilantin sodium on the lungs. New Eng. J. Med. 264: 648, 1961. CrossrefMedlineGoogle Scholar95. FINKELMANARIEFF IAJ: Untoward effects of phenytoin sodium in epilepsy. JAMA 118: 1209, 1942. CrossrefGoogle Scholar96. HARRISKOKERNOT ASRH: Effects of diphenylhydantoin sodium (Dilantin sodium) and phenobarbital sodium upon ectopic ventricular tachycardia in acute myocardial infarction. Amer. J. Physiol. 163: 505, 1950. CrossrefMedlineGoogle Scholar97. MOSELYTYLER LMD: The effect of diphenylhydantoin sodium (Dilantin), procaine hydrochloride, procaine amide hydrochloride, and quinidine hydrochloride upon ouabain-induced ventricular tachycardia in unanesthetized dogs. Circulation 10: 65, 1954. CrossrefMedlineGoogle Scholar98. LEONARD WA: The use of diphenylhydantoin (Dilantin) sodium in the treatment of ventricular tachycardia. Arch. Intern. Med. (Chicago) 101: 714, 1958. CrossrefGoogle Scholar99. SCHERFBLUMENFELDTANERYILDIE DSDM: The effect of diphenylhydantoin (Dilantin) sodium on atrial flutter and fibrillation provoked by focal application of aconitine or delphinine. Amer. Heart J. 60: 936, 1960. CrossrefMedlineGoogle Scholar100. CARLEN SA: Congestive heart failure caused by sensitivity to diphenylhydantoin (Dilantin sodium). Canad. Med. Ass. J. 80: 725, 1959. MedlineGoogle Scholar101. VAN HUYSSTEEN MP: Conjunctival ulceration as a complication in the treatment of epilepsy. S. Afr. Med. J. 27: 626, 1953. MedlineGoogle Scholar102. FINCHLORBER EJ: Methaemoglobinaemia in the newborn. Probably due to phenytoin excreted in human milk. J. Obstet. Gynaec. Brit. Comm. 61: 833, 1954. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MARSHALL SPARBERG, M.D.Affiliations: Chicago, IllinoisFrom Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.Requests for reprints should be addressed to Marshall Sparberg, M.D., 1121 Skokie Ridge Drive, Glencoe, Illinois. 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LUDWIG, M.D., F.A.C.P., LOUIS B. CHAYKIN, M.D., ANTONIO V. ESCUETA, M.D.Electroencephalographic findings in a case of acute reaction to dilantinFindings suggestive of systemic lupus erythematosus in subjects on chronic anticonvulsant therapyDiphenylhydantoin Sodium in Cardiac ArrhythmiasDiphenylhydantoin-induced hypersensitivity reactionSOME OBSERVATIONS ON SURGICAL HYPOTHERMIA BY MEANS OF EXTENSIVE RADIANT COOLINGDRUG-INDUCED IN-VITRO STIMULATION OF PERIPHERAL LYMPHOCYTES 1 December 1963Volume 59, Issue 6Page: 914-930KeywordsFolic acidLeukocytosisLymphomaMegaloblastic anemiaNauseaParalysisProteinsSaltsSarcomaThyroid ePublished: 1 December 2008 Issue Published: 1 December 1963 PDF downloadLoading ...