title: Phenytoin toxicity in two-month-old Thai infant with CYP2C9 gene polymorphism--A case report.
abstract: Phenytoin is one of the most well established and most effective antiepileptic medications for the treatment of focal seizures. In our clinical practice, it has proven difficult to maintain therapeutic phenytoin levels in infants less than three months of age. Incidence of phenytoin toxicity in infants is very rare. The cytochrome P450 super family plays an important role in phenytoin metabolism, especially CYP2C9 and CYP2C19. In this case report, we profiled a two-month-old Thai infant who developed phenytoin toxicity resulting from CYP2C9 gene polymorphism.
authors.affiliation: Division of Neurology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand; Division of Neurology, Department of Pediatrics, King Chulalongkorn Memorial Hospital/Thai Red Cross Society, Thailand. Electronic address: vmontida@hotmail.com.
authors.forename: Montida
authors.initials: M
authors.lastname: Veeravigrom
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand.
authors.forename: Vorapol
authors.initials: V
authors.lastname: Jaroonvanichkul
authors.affiliation: Division of Neurology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand; Division of Neurology, Department of Pediatrics, King Chulalongkorn Memorial Hospital/Thai Red Cross Society, Thailand.
authors.forename: Wiracha
authors.initials: W
authors.lastname: Netbaramee
authors.affiliation: Division of Neurology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand; Division of Neurology, Department of Pediatrics, King Chulalongkorn Memorial Hospital/Thai Red Cross Society, Thailand.
authors.forename: Pichaya
authors.initials: P
authors.lastname: Phaisarn
authors.affiliation: Division of Neurology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand; Division of Neurology, Department of Pediatrics, King Chulalongkorn Memorial Hospital/Thai Red Cross Society, Thailand.
authors.forename: Thanita
authors.initials: T
authors.lastname: Uyathanarat
mesh_terms: D001003:Anal Canal / Q000002:abnormalities / Q000503:physiopathology; D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use / Q000633:toxicity*; D065729:Cytochrome P-450 CYP2C9 / Q000235:genetics*; D004947:Esophagus / Q000002:abnormalities / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007668:Kidney / Q000002:abnormalities / Q000503:physiopathology; D017880:Limb Deformities, Congenital / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D008297:Male; D010672:Phenytoin / Q000493:pharmacokinetics / Q000627:therapeutic use / Q000633:toxicity*; D011110:Polymorphism, Genetic; D012640:Seizures / Q000188:drug therapy / Q000503:physiopathology; D013131:Spine / Q000002:abnormalities / Q000503:physiopathology; D013785:Thailand; D014132:Trachea / Q000002:abnormalities / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin; C450260:CYP2C9 protein, human; D065729:Cytochrome P-450 CYP2C9
keywords: CYP2C9 gene polymorphism; Infant; Phenytoin toxicity