Necrotizing vasculitis associated with diphenylhydantoin: Two fatal cases

Yermakov, Valentin; Hitti, Ibrahim F.; Sutton, Albert L.

doi:10.1016/s0046-8177(83)80248-2

Cited by 47 publications

(10 citation statements)

References 8 publications

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“…When present, cutaneous rash or pleural effusion increase the likelihood of the diagnosis. Associated extrapulmonary iatrogenic manifestations such as systemic eosinophilic vasculitis (thus mimicking CSS) have been reported (154, 155).…”

Section: Eosinophilic Pneumonias Secondary To Drug Toxic Agents and mentioning

confidence: 99%

Eosinophilic pneumonias

Cottin

Lazor

2005

Allergy

184

115

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Eosinophilic pneumonias (EP) encompass a wide spectrum of lung diseases characterized by peripheral blood eosinophilia (>1 × 109 eosinophils/l) and/or alveolar eosinophilia (>25%). Blood eosinophilia may be lacking, as in the early phase of idiopathic acute EP, or in patients already taking oral corticosteroids. EP may present with varying severity, ranging from almost asymptomatic infiltrates to the acute respiratory distress syndrome necessitating mechanical ventilation. Possible causes of EP must be thoroughly investigated, especially drugs and the variety of parasitic infections (considering history of travel or residence in areas of endemic parasitic infection). However, chronic EP remains idiopathic in many cases. When present, extrathoracic manifestations lead to suspect Churg–Strauss syndrome (CSS) or the hypereosinophilic syndrome (HES), the prognosis of which is dominated by cardiac involvement. Apart from the treatment of specific causes when possible, corticosteroids remain the cornerstone of symptomatic treatment for eosinophilic disorders, usually with a dramatic response, but frequent relapses when tapering or after stopping the treatment. The adjunction of immunosuppressants to corticosteroids is necessary in patients with CSS and poor prognosis factors. Imatinib has recently proven effective in the treatment of the myeloproliferative variant of the HES.

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Section: Eosinophilic Pneumonias Secondary To Drug Toxic Agents and mentioning

confidence: 99%

Eosinophilic pneumonias

Cottin

Lazor

2005

Allergy

184

115

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“…These include interstitial pneumonitis,[11] necrotizing vasculitis[13] and lymphocytic interstitial pneumonitis,[14] etc. The case presented here showed not only abnormal pulmonary functions but radiological infiltrates also, along with features of chronic interstitial pneumonitis on tissue examination; further elucidating the nature of DPH-induced pulmonary changes.…”

Section: Discussionmentioning

confidence: 99%

Diphenylhydantoin (phenytoin)-induced chronic pulmonary disease

Dixit

Nuwal

et al. 2009

Lung India

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Drug-induced respiratory diseases are difficult to diagnose and therefore usually not identified, probably underestimated and under-reported. We report a case of diphenylhydantoin/phenytoin-induced chronic pulmonary disease in a 62-year-old male patient presenting with progressive dyspnea, eosinophilia, and pulmonary abnormalities. The importance of drug history in clinical history-taking and early diagnosis of drug-induced respiratory diseases is emphasized so as to prevent permanent pulmonary damage.

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“…Fatal cases caused by systemic hypersensitivity vasculitis against various drugs (e.g. phenytoin and phenylhydantoin) have been described [3,6].…”

Section: Discussionmentioning

confidence: 99%

Wegener’s granulomatosis in the thyroid mimicking a tumour

et al. 2008

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Wegener's granulomatosis (WG) is a systemic vasculitis characterised by the presence of necrotizing granulomas and classically manifests as a triad of upper and lower respiratory tract involvement along with glomerulonephritis. Other rather unusual presentations of WG include ocular, salivary gland, cutaneous, gastrointestinal and cardiac involvement. We report a case in a 51-year-old woman suffering from WG with positive antineutrophil cytoplasmic autoantibodies and antibodies directed against proteinase 3. Under maintenance therapy, the patient developed two thyroid nodules suspicious for malignancy which led to thyroidectomy. Postoperative histological examination revealed a tumour-forming WG mimicking a malignant thyroid tumour. We conclude that, although extremely rare, Wegener's. granulomatosis should be added to the list of differential diagnoses of tumours of the thyroid gland.

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Necrotizing vasculitis associated with diphenylhydantoin: Two fatal cases

Cited by 47 publications

References 8 publications

Eosinophilic pneumonias

Eosinophilic pneumonias

Diphenylhydantoin (phenytoin)-induced chronic pulmonary disease

Wegener’s granulomatosis in the thyroid mimicking a tumour

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