Systemic lupus erythematosus triggered by diphenlhydantoin

Gleichmann, Helga

doi:10.1002/art.1780251121

Cited by 13 publications

(6 citation statements)

References 10 publications

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“…181 Similar to several other anticonvulsants phenytoin is associated with a low but significant incidence of DILE (SLE-like). 182 One case of phenytoin-induced SCLE has been described in a 73-year-old woman with detectable antibodies to Ro/SSA, La/SSB, and histones. 183 Despite the promising data from a single study, no further trials with phenytoin in CLE have been published since 1995, which might be a result of the growing evidence of severe side effects.…”

Section: Historical Medications Phenytoinmentioning

confidence: 99%

Cutaneous lupus erythematosus: Update of therapeutic options

Kuhn

Ruland

Bonsmann

2011

Journal of the American Academy of Dermatology

121

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Section: Historical Medications Phenytoinmentioning

confidence: 99%

Cutaneous lupus erythematosus: Update of therapeutic options

Kuhn

Ruland

Bonsmann

2011

Journal of the American Academy of Dermatology

121

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“…Phenytoin has been said to induce subacute lupus [108], dermatomyositis [109], systemic lupus with vasculitis [110], systemic lupus with arthritic manifestations [111], and alopecia linked with lupus [112]. Lupus can occur in children taking phenytoin [113].…”

Section: Collagen Vascular-like Side Effectsmentioning

confidence: 99%

Impact of phenytoin therapy on the skin and skin disease

Scheinfeld¹

2004

Expert Opinion on Drug Safety

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Phenytoin (diphenylhydantoin; Dilantin), ALZA Corp.) is a highly effective and widely prescribed anticonvulsant agent used in the treatment of focal and tonic clonic generalised seizures. The side effects of phenytoin can occassionally engender significant morbidity. Phenytoin can induce generalised eruptions that include: a maculopapular exanthem, Stevens-Johnson syndrome, generalised exfoliative dermatitis, toxic epidermal necrolysis, vasculitis and fixed drug eruptions. Phenytoin is linked to a hypersensitivity syndrome that manifests with fever, rash and lymphadenopathy. Patients receiving phenytoin may develop pseudolymphoma or, rarely, malignant lymphoma and mycosis fungoides-like lesions. Rarer cutaneous side effects include drug-induced lupus, purple hand syndrome, pigmentary alterations and IgA bullous dermatosis. Phenytoin can effect clotting function and alter vitamin and mineral levels. Prenatal exposure to phenytoin may result in a spectrum of structural, developmental and behavioural changes, known as the fetal hydantoin syndrome. Patients who use phenytoin in the long-term commonly manifest with gingival hyperplasia, coarsening of the facies, and hirsutism.

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“…15 Anti-Smith an tibodies are usually absent in drug-induced SLE. 4,13 Slow acetylator status, 4 graft-versus-host-like reaction, 16 and inhibition of DNA methylation on Τ cells 17 have been pro posed as possible explanations for drug-induced SLE.…”

Section: Case Reportmentioning

confidence: 99%

Drug-Induced Lupus Due to Phenytoin

Siragusa¹,

Ramos‐Caro²,

Edwards³

et al. 2000

Journal of Pharmacy Technology

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To report a case of lupus erythematosus induced by long-term use of phenytoin and to discuss the clinical aspects of drug-induced lupus. Case Summary: A 67-year-old white man who had been taking phenytoin for approximately 15 years was hospitalized due to fever, pericarditis, severe abdominal pain, malaise, and weight loss. Laboratory studies revealed a positive antinuclear antibody assay in a titer of 1:80 in a homogeneous pattern, a strong positive antihistone antibody test, an elevated erythrocyte sedimentation rate (115 mm/h), and neutrophilia (20,800 cells/mm 3 ). All symptoms and signs disappeared, and the laboratory abnormalities returned to normal within a few weeks after discontinuing phenytoin. The patient was not rechallenged.Discussion: Drug-induced lupus has been reported to typically occur within a few years after starting the medication responsible. Musculoskeletal complaints are the most common manifestations of drug-induced lupus. Pleural effusions, pericarditis, and pulmonary infiltrates have also been reported. Cutaneous findings are uncommon, and renal involvement is rare. Conclusions:Our case is unusual in that the patient had been taking phenytoin for approximately 15 years before developing lupus.

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Systemic lupus erythematosus triggered by diphenlhydantoin

Cited by 13 publications

References 10 publications

Cutaneous lupus erythematosus: Update of therapeutic options

Cutaneous lupus erythematosus: Update of therapeutic options

Impact of phenytoin therapy on the skin and skin disease

Drug-Induced Lupus Due to Phenytoin

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