Phenytoin hepatotoxicity masked by corticosteroids.
The association of phenytoin and liver toxicity is well documented. This article describes a patient who underwent a transsphenoidal resection of a pituitary tumor who developed phenytoin-induced hepatotoxicity that was masked by the simultaneous administration of corticosteroids for treatment of cerebral edema. In a patient receiving both medications, the systemic manifestations of the hypersensitivity to phenytoin may go unrecognized, leading to delayed identification of a potentially lethal complication of this commonly prescribed anticonvulsant.
Lisker-Melman
M
M
Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892.
Hoofnagle
J H
JH
D001929:Brain Edema / Q000188:drug therapy; D056486:Chemical and Drug Induced Liver Injury; D003907:Dexamethasone / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects*; D010911:Pituitary Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy; D012640:Seizures / Q000188:drug therapy / Q000209:etiology
D010672:Phenytoin; D003907:Dexamethasone