Charcoal hemoperfusion in an elderly man with life-threatening adverse reactions due to poor metabolism of phenytoin.
A 77-year-old man presented with dizziness and ataxia after 7-day treatment of phenytoin 100 mg 3 times daily for prophylaxis of post-traumatic seizure. Thrombocytopenia and hematuria were found incipiently and supportive measures were employed. Owing to extremely slow metabolism of phenytoin in this patient, the period of exposure to phenytoin overdose was prolonged, resulting in delayed hypersensitivity syndrome. Neutropenia and fever developed and thus antibiotics and granulocyte-colony stimulating factor were administered. Although charcoal hemoperfusion is generally not applied in cases of phenytoin overdose, this method was successfully used to enhance the removal of phenytoin in our patient.
Sung
Sheng-Feng
SF
Department of Neurology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Chiang
Pei-Chun
PC
Tung
Hsiu-Hua
HH
Ong
Cheung-Ter
CT
D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000493:pharmacokinetics; D002606:Charcoal; D004342:Drug Hypersensitivity / Q000209:etiology / Q000628:therapy*; D062787:Drug Overdose; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D010672:Phenytoin / Q000009:adverse effects* / Q000493:pharmacokinetics
D000927:Anticonvulsants; D002606:Charcoal; D010672:Phenytoin