Phenytoin-induced thrombocytopenia treated with intravenous immune globulin.
OBJECTIVE
To describe the use of intravenous immune globulin (IVIG) in an 8-year-old girl with phenytoin-induced thrombocytopenia and leukopenia.


METHODS
An 8-year-old girl had fever, rash, thrombocytopenia, and leukopenia 18 days after initiation of phenytoin therapy. The phenytoin level was elevated. She was treated with 1 g/kg of IVIG.


RESULTS
The thrombocytopenia improved dramatically after IVIG therapy. There was a slower response to the leukopenia.


CONCLUSIONS
Phenytoin hypersensitivity can present with thrombocytopenia and leukopenia. Treatment with IVIG was associated with a rapid rise in the platelet count in the patient in this report. IVIG should be considered for patients with phenytoin-induced thrombocytopenia.
Salzman
M B
MB
Department of Pediatrics, Kaiser Permanente West Los Angeles Medical Center, CA 90034, USA.
Smith
E M
EM
D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007970:Leukopenia / Q000139:chemically induced / Q000188:drug therapy; D010672:Phenytoin / Q000009:adverse effects* / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy*
D000927:Anticonvulsants; D016756:Immunoglobulins, Intravenous; D010672:Phenytoin