Agranulocytosis Following Treatment With Phenylindanedione

Hepatitis Due to Phenindione Sensitivity

“…The present case closely resembles three of the previously recorded cases (Kirkeby, 1954;East and Beamish, 1957;Burns and Desmond, 1958) in the mild elevation of serum bilirubin and in the normality of serum flocculation tests and the serum protein estimation.…”

“…In four previous cases of hepatitis, this has followed about four days after the onset of fever (Kirkeby, 1954;Makous and Vander Veer, 1954;East and Beamish, 1957;Burns and Desmond, 1958). It is of interest that bilirubin was found in the urine of this case within 24 hours of the onset of fever and two days before there was any liver enlargement.…”

Phenindione Jaundice

“…The rash that normally accompanies these prodromal symptoms has in a few cases appeared with the jaundice or even a few days later (Perkins, 1962). Six patients with renal disease due to phenindione have now been recorded, of whom 4 died (Galea, Young, and Bell, 1963): in one the urxmia was associated with jaundice (Kirkeby, 1954). In the reported cases of phenindione jaundice, eosinophilia occurred in 7, neutropenia in 3, and atypical monocytes in 4.…”

Phenindione sensitivity with leukaemoid reaction and hepato-renal damage

“…Four cases have been fatal, but two were associated with agranulocytosis (Kirkeby, 1954;Burns & Desmond, 1958), one with nephropathy (Turiaf, 1965) and one with oliguric renal failure (Smith, 1965). The degree of hepatocellular damage in the present case seems to be unusually severe, the serum albumin dropping to 1-6 g/100 ml, the bilirubin rising to 17 mg/100 ml; though in the case described by Makous & Vander Veer (1954) the bilirubin rose to 14 with a high thymol turbidity.…”

“…Most have presented a cholestatic picture (Burns & Desmond, 1958;Wallace, 1960), but some have shown a significant degree of hepatocellular damage (Makous & Vander Veer, 1954;East & Beamish, 1957;Perkins, 1962b;Baker & Williams, 1963;Mohamed, 1965) -and in some the picture has been mixed. Four cases have been fatal, but two were associated with agranulocytosis (Kirkeby, 1954;Burns & Desmond, 1958), one with nephropathy (Turiaf, 1965) and one with oliguric renal failure (Smith, 1965). The degree of hepatocellular damage in the present case seems to be unusually severe, the serum albumin dropping to 1-6 g/100 ml, the bilirubin rising to 17 mg/100 ml; though in the case described by Makous & Vander Veer (1954) the bilirubin rose to 14 with a high thymol turbidity.…”